Nursing Elites

1. While in an induced coma for 3 weeks, a badly burned firefighter awakens and thanks his son for singing Happy Birthday to him a week earlier. Which part of the brain is responsible for allowing him to hear and comprehend while comatose?

• A. Cerebellum
• B. Thalamus
• C. Temporal lobe
• D. Occipital lobe

Correct answer: C

Rationale: The temporal lobe is responsible for processing auditory information, allowing the patient to hear and comprehend while in a coma. The cerebellum is primarily associated with coordination and balance, not auditory processing. The thalamus serves as a relay station for sensory information but is not specifically responsible for auditory processing. The occipital lobe is mainly involved in processing visual information, not auditory functions.

2. A 34-year-old woman has presented to the clinic for the first time, and the nurse learns that she has been taking Depo Provera for the past 13 years. This aspect of the woman's medical history should prompt what assessment?

• A. Cardiac stress testing
• B. Renal ultrasound
• C. Bone density testing
• D. Evaluation of triglyceride levels

Correct answer: C

Rationale: The correct answer is bone density testing (Choice C). Long-term use of Depo Provera, a hormonal contraceptive, is associated with decreased bone mineral density. Assessing bone density is crucial to monitor for potential osteoporosis. Cardiac stress testing (Choice A) is not indicated based on the medication history provided. Renal ultrasound (Choice B) and evaluation of triglyceride levels (Choice D) are not directly related to the use of Depo Provera.

3. When does pain in the lower extremities due to peripheral artery disease usually worsen?

• A. with rest because blood flow decreases.
• B. with elevation of the extremity because blood is diverted away.
• C. when the leg is in a dependent position because blood pools.
• D. when the leg is touched or massaged because cytokines are released.

Correct answer: B

Rationale: Pain in the lower extremities due to peripheral artery disease usually worsens with elevation of the extremity because blood is diverted away from the affected area, leading to decreased perfusion and exacerbation of symptoms. Choices A, C, and D are incorrect because resting, dependent position, and touch/massage do not typically worsen the pain associated with peripheral artery disease.

4. A 5-year-old male presents with low-set ears, a fish-shaped mouth, and involuntary rapid muscular contraction. Laboratory testing reveals decreased calcium levels. Which of the following diagnoses is most likely?

• A. B cell deficiency
• B. T cell deficiency
• C. Combined immunodeficiency
• D. Complement deficiency

Correct answer: B

Rationale: The correct answer is B: T cell deficiency. The symptoms described in the case, including low-set ears, a fish-shaped mouth, involuntary rapid muscular contraction, and decreased calcium levels, are indicative of DiGeorge syndrome. This syndrome is characterized by T cell deficiency due to thymic hypoplasia. B cell deficiency (Choice A), combined immunodeficiency (Choice C), and complement deficiency (Choice D) do not align with the clinical presentation and laboratory findings provided in the case. Therefore, T cell deficiency is the most likely diagnosis in this scenario.

5. Which of the following is a cause of edema?

• A. Decreased plasma proteins
• B. Hypotension
• C. Dehydration
• D. Polyuria

Correct answer: A

Rationale: The correct answer is A: Decreased plasma proteins. Edema can be caused by decreased plasma proteins, which reduce the osmotic pressure that keeps fluid in the blood vessels. Hypotension (choice B) is low blood pressure and is not a direct cause of edema. Dehydration (choice C) involves a lack of body fluid, but it is not a direct cause of edema. Polyuria (choice D) is excessive urination and not a direct cause of edema.

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