Nursing Elites

1. A 44-year-old man presents with muscle weakness and fatigue. He states that he has experienced difficulty climbing stairs and even holding his arms up to comb his hair. Which test is most likely to help confirm the diagnosis?

• A. Electromyography (EMG)
• B. Nerve conduction studies
• C. Muscle biopsy
• D. Blood test for autoantibodies

Correct answer: A

Rationale: The correct answer is Electromyography (EMG). EMG is commonly used to diagnose conditions involving muscle weakness and fatigue, such as myasthenia gravis. Nerve conduction studies primarily assess nerve function rather than muscle involvement. While a muscle biopsy can provide valuable information, EMG is more specific for evaluating muscle function in this context. A blood test for autoantibodies may be helpful in certain autoimmune conditions but is not the primary test for confirming the diagnosis based on the patient's symptoms of muscle weakness and fatigue.

2. Which of the following is a characteristic of disseminated intravascular coagulation (DIC)?

• A. Simultaneous stroke and heart attack
• B. Simultaneous clotting and bleeding
• C. Simultaneous clotting and insulin release
• D. Simultaneous bleeding and vomiting

Correct answer: B

Rationale: Disseminated intravascular coagulation (DIC) is characterized by simultaneous clotting and bleeding throughout the body. This imbalance in the body's clotting system leads to the formation of blood clots in small blood vessels, which can consume clotting factors and platelets, ultimately leading to excessive bleeding. Choices A, C, and D are incorrect because they do not describe the characteristic feature of DIC, which involves both clotting and bleeding.

3. What causes hepatic encephalopathy?

• A. A brain infection
• B. Increased ammonia levels in the bloodstream
• C. Decreased albumin blood levels
• D. Untreated chronic bronchitis

Correct answer: B

Rationale: Hepatic encephalopathy is caused by increased ammonia levels in the bloodstream. Ammonia, a byproduct of protein metabolism normally processed by the liver, accumulates in the bloodstream when the liver is unable to function properly. This excess ammonia affects brain function, leading to symptoms of hepatic encephalopathy. Choices A, C, and D are incorrect because they do not directly relate to the pathophysiology of hepatic encephalopathy.

4. When starting on oral contraceptives, what important information should the nurse provide regarding the timing of the medication?

• A. Oral contraceptives must be taken at the same time each day to maintain consistent hormone levels and ensure effectiveness in preventing pregnancy.
• B. Oral contraceptives can be taken at any time of day as long as the schedule is consistent.
• C. Oral contraceptives should be taken with food to enhance absorption.
• D. Oral contraceptives can be skipped occasionally without significant consequences.

Correct answer: A

Rationale: When starting on oral contraceptives, it is crucial to take them at the same time each day to maintain consistent hormone levels and ensure effectiveness in preventing pregnancy. Choice B is incorrect because consistency in timing is essential for optimal efficacy. Choice C is inaccurate as oral contraceptives do not need to be taken with food for absorption. Choice D is incorrect because missing doses or skipping oral contraceptives can reduce their effectiveness in preventing pregnancy.

5. Why does multiple sclerosis manifest as asymmetrical and in different parts of the body?

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: C

Rationale: Multiple sclerosis is characterized by the immune system mistakenly attacking the myelin sheath in the central nervous system. This results in the formation of lesions that can occur in different parts of the central nervous system, leading to varied symptoms depending on the location of the damage. Choice A is the correct answer because it accurately describes the pathophysiology of multiple sclerosis. Choices B, C, and D are incorrect because they describe mechanisms or locations that are not associated with the pathogenesis of multiple sclerosis.

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