Nursing Elites

1. A client on an acute medicine unit of a hospital with a diagnosis of small bowel obstruction is reporting intense, diffuse pain in her abdomen. Which physiologic phenomenon is most likely contributing to her complaint?

• A. Somatic pain resulting from pressure on the parietal peritoneum
• B. Referred pain from her small bowel
• C. Visceral pain resulting from distension and ischemia
• D. Neuropathic pain resulting from autonomic dysfunction

Correct answer: C

Rationale: Visceral pain is associated with distension, ischemia, and inflammation of internal organs. In the case of a small bowel obstruction, the intense, diffuse pain reported by the client is likely due to the distension and ischemia of the small bowel. Somatic pain (Choice A) would be more localized and sharp, typically arising from the parietal peritoneum. Referred pain (Choice B) is pain perceived at a site distant from the actual pathology. Neuropathic pain (Choice D) involves dysfunction or damage to the nervous system and is not typically associated with the described physiologic phenomenon of distension and ischemia in the context of a small bowel obstruction.

2. A child's thymus gland is fully formed and proportionately larger than an adult's. Which of the following processes that contribute to immunity takes place in the thymus gland?

• A. Differentiation of B cells
• B. Production of natural killer (NK) cells
• C. Proliferation of T cells
• D. Filtration of antigens from the blood

Correct answer: C

Rationale: The correct answer is C: Proliferation of T cells. The thymus gland is responsible for the maturation and proliferation of T cells, which play a crucial role in adaptive immunity. Option A, differentiation of B cells, is incorrect because B cell maturation primarily occurs in the bone marrow. Option B, production of natural killer (NK) cells, is incorrect as NK cells are mainly produced in the bone marrow and lymph nodes. Option D, filtration of antigens from the blood, is incorrect as antigen filtration is not a primary function of the thymus gland.

3. A patient's anemia is described as having erythrocytes that demonstrate anisocytosis. The nurse would recognize the erythrocytes as:

• A. Pale in color
• B. Present in various sizes
• C. Able to assume various shapes
• D. Live only a few days

Correct answer: B

Rationale: The correct answer is B: 'Present in various sizes.' Anisocytosis refers to erythrocytes that are present in various sizes, indicating an abnormality in the uniformity of red blood cell size. Choice A is incorrect because anisocytosis does not refer to the color of erythrocytes. Choice C is incorrect as anisocytosis does not involve the shape of erythrocytes. Choice D is incorrect as anisocytosis does not determine the lifespan of erythrocytes.

4. Nurse Sharie is assessing a parent who abused her child. Which of the following risk factors would the nurse expect to find in this case?

• A. Flexible role functioning between parents
• B. History of the parent having been abused as a child
• C. Single-parent home situation
• D. Presence of parental mental illness

Correct answer: B

Rationale: The correct answer is B: 'History of the parent having been abused as a child.' Research shows that a history of being abused as a child is a significant risk factor for child abuse. This cycle of abuse can sometimes continue from one generation to the next. Choices A, C, and D are incorrect. Flexible role functioning between parents, a single-parent home situation, and the presence of parental mental illness are important factors to consider in various contexts but may not specifically indicate a higher likelihood of child abuse in this case.

5. A 67-year-old man is receiving androgen therapy for osteoporosis. What laboratory test should the nurse monitor during this therapy?

• A. Liver function tests
• B. Blood glucose levels
• C. Prostate-specific antigen (PSA)
• D. Cholesterol levels

Correct answer: A

Rationale: During androgen therapy, monitoring liver function tests is crucial to detect any signs of liver dysfunction. Androgens can potentially impact liver function, making it essential to monitor enzymes such as ALT and AST. While blood glucose levels and cholesterol levels are important parameters to monitor in certain situations, they are not the primary focus during androgen therapy for osteoporosis. Prostate-specific antigen (PSA) monitoring is more relevant in the context of prostate health and cancer screening, not specifically during androgen therapy for osteoporosis.

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