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. A nurse caring for a patient with a diagnosis of lung cancer is aware that the primary risk factor for developing lung cancer is:

• A. Alcohol consumption
• B. Smoking
• C. Poor diet
• D. Environmental exposure

Correct answer: B

Rationale: The correct answer is B: Smoking. Smoking is the primary risk factor for developing lung cancer. Tobacco smoke contains numerous carcinogens that can damage the cells in the lungs, leading to the development of cancer. Alcohol consumption (Choice A), poor diet (Choice C), and environmental exposure (Choice D) can contribute to overall health risks, but they are not the primary risk factors specifically associated with the development of lung cancer.

3. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?

• A. Has your child received all recommended vaccinations?
• B. Has your child been feeding poorly or showing signs of constipation?
• C. Has your child been exposed to any sick individuals?
• D. Has your child been displaying signs of respiratory distress?

Correct answer: B

Rationale: The correct answer is B. Poor feeding and constipation are common early symptoms of infant botulism, which is caused by a neurotoxin that impairs muscle function. Option A is unrelated to the presentation of botulism. Option C does not directly relate to the symptoms of botulism. Option D is more indicative of respiratory issues rather than the constellation of symptoms seen in botulism.

4. A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with the absorption of alendronate. Taking the medication at bedtime (choice C) is not necessary for optimal absorption. Taking the medication with food (choice D) is also not recommended as food can reduce the absorption of alendronate.

5. An infant is being administered an immunization. Which of the following provides an accurate description of an immunization?

• A. It should be administered to a pregnant woman prior to the infant's birth.
• B. It is the administration of an antigen to stimulate an antibody response.
• C. It produces many adverse reactions, particularly autism, in the infant.
• D. It protects the infant from exposure to infectious antibodies.

Correct answer: B

Rationale: The correct answer is B. Immunization involves administering an antigen, such as a weakened or killed microorganism, to stimulate the immune system to produce an antibody response. This process helps the body recognize and remember specific pathogens, providing immunity against future infections. Choice A is incorrect because immunizations are administered to the infant directly, not to the pregnant woman before birth. Choice C is incorrect as there is no scientific evidence linking immunizations to autism. Choice D is incorrect as immunizations protect against infectious agents, not antibodies.

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