Nursing Elites

1. A 56-year-old woman has been experiencing memory loss and confusion for the past year. The client is diagnosed with Alzheimer's disease. Which finding is most characteristic of this disease?

• A. Neurofibrillary tangles in the brain
• B. Demyelination of neurons in the brain
• C. Accumulation of beta-amyloid plaques
• D. Formation of Lewy bodies

Correct answer: C

Rationale: The correct answer is C: Accumulation of beta-amyloid plaques. Alzheimer's disease is characterized by the accumulation of beta-amyloid plaques in the brain. These plaques are formed from the buildup of beta-amyloid protein fragments between nerve cells. Choice A, neurofibrillary tangles, are a hallmark of another neurodegenerative disease called Alzheimer's disease. Choice B, demyelination of neurons, is more characteristic of diseases like multiple sclerosis. Choice D, formation of Lewy bodies, is associated with Lewy body dementia, not Alzheimer's disease.

2. What important instruction should the nurse provide about taking medroxyprogesterone acetate (Provera) for a patient with endometriosis?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Medroxyprogesterone should be taken with food to reduce gastrointestinal upset.
• C. Discontinue medroxyprogesterone if side effects occur.
• D. Medroxyprogesterone should be taken once a week to maintain effectiveness.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. This consistency is crucial for achieving therapeutic outcomes. Choice B is incorrect because medroxyprogesterone should be taken at the same time each day, regardless of food intake. Choice C is incorrect because side effects should be reported to the healthcare provider for further evaluation rather than discontinuing the medication abruptly. Choice D is incorrect as medroxyprogesterone is usually taken daily for the prescribed duration.

3. A client has approached the nurse asking for advice on how to deal with his alcohol addiction. The nurse should tell the client that the only effective treatment for alcoholism is:

• A. psychotherapy.
• B. total abstinence.
• C. Alcoholics Anonymous (AA).
• D. aversion therapy.

Correct answer: B

Rationale: The correct answer is B: total abstinence. Total abstinence from alcohol is considered the most effective treatment for alcoholism. This approach eliminates the risk of relapse and helps individuals maintain sobriety. While psychotherapy can be beneficial in addressing underlying issues, total abstinence is crucial in overcoming alcohol addiction. Alcoholics Anonymous (AA) is a supportive group that can complement treatment, but it is not the only effective approach. Aversion therapy aims to create a negative association with alcohol but may not address the underlying causes of addiction, making total abstinence a more comprehensive and recommended approach.

4. Which of the following is an example of a Type 1 hypersensitivity reaction?

• A. Anaphylaxis
• B. Indigestion
• C. Beta cell destruction
• D. ABO transfusion reaction

Correct answer: A

Rationale: Anaphylaxis is a classic example of a Type 1 hypersensitivity reaction. In Type 1 hypersensitivity, allergens trigger an immediate immune response mediated by IgE antibodies, leading to the release of histamine and other mediators. This reaction can result in symptoms ranging from mild itching and hives to severe conditions like anaphylaxis, which is a life-threatening emergency. The other options, such as indigestion (choice B), beta cell destruction (choice C), and ABO transfusion reaction (choice D), are not classified as Type 1 hypersensitivity reactions. Indigestion is typically related to gastrointestinal disturbances, beta cell destruction is associated with autoimmune conditions like type 1 diabetes, and ABO transfusion reaction involves antibodies targeting incompatible blood groups, which is a different immune mechanism compared to Type 1 hypersensitivity.

5. A client with a history of chronic alcoholism presents to the emergency department with a complaint of double vision. Which cranial nerve is most likely involved?

• A. Cranial nerve I (Olfactory)
• B. Cranial nerve III (Oculomotor)
• C. Cranial nerve VI (Abducens)
• D. Cranial nerve VII (Facial)

Correct answer: C

Rationale: The correct answer is Cranial nerve VI (Abducens). Chronic alcoholism can lead to damage to the abducens nerve, which controls the lateral movement of the eye. This damage can result in symptoms like double vision. Cranial nerve I (Olfactory) is responsible for the sense of smell and is not related to eye movement. Cranial nerve III (Oculomotor) controls most of the eye movements but is less likely to be affected in chronic alcoholism than the abducens nerve. Cranial nerve VII (Facial) is responsible for facial movements and is not associated with double vision.

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