Nursing Elites

1. A client with a diagnosis of depression has been prescribed a medication that ultimately increases the levels of the neurotransmitter serotonin between neurons. Which process will accompany the actions of the neurotransmitter in a chemical synapse?

• A. Two-way communication between neurons is permitted, in contrast to the one-way communication in electrical synapses.
• B. Communication between a neuron and the single neuron it is connected with will be facilitated.
• C. The neurotransmitter will cross gap junctions more readily.
• D. More neurotransmitters will cross the synaptic cleft and bond with postsynaptic receptors.

Correct answer: D

Rationale: When serotonin levels increase, more neurotransmitters will cross the synaptic cleft and bind with postsynaptic receptors, facilitating enhanced communication. Option A is incorrect because chemical synapses, unlike electrical synapses, are unidirectional. Option B is incorrect because neurotransmitters impact communication with multiple neurons, not just a single connected neuron. Option C is incorrect because neurotransmitters cross the synaptic cleft, not gap junctions.

2. Which physiologic response is most likely to accompany activation of the parasympathetic nervous system?

• A. Increased heart rate
• B. Increased gastric motility
• C. Pupil dilation
• D. Sweating

Correct answer: B

Rationale: The correct answer is B: Increased gastric motility. The parasympathetic nervous system is known to promote rest and digest functions, which includes increasing gastric motility to aid in digestion. Choices A, C, and D are incorrect as they are more characteristic of the sympathetic nervous system. The sympathetic nervous system is responsible for the fight or flight response, leading to increased heart rate (Choice A), pupil dilation (Choice C), and sweating (Choice D) among other responses.

3. In discussing sex hormone production with the patient, the nurse should describe that testosterone is normally secreted in response to

• A. sexual arousal.
• B. stimulation by luteinizing hormone.
• C. ACTH release by the adrenal cortex.
• D. decreased cortisol levels.

Correct answer: B

Rationale: Testosterone production is regulated by the hypothalamic-pituitary-gonadal axis. Luteinizing hormone (LH) stimulates the Leydig cells in the testes to produce testosterone. Therefore, the correct answer is B. Choice A, 'sexual arousal,' is incorrect because testosterone secretion is not directly linked to arousal but rather to hormonal stimulation. Choice C, 'ACTH release by the adrenal cortex,' is incorrect as testosterone production is not primarily regulated by adrenocorticotropic hormone (ACTH). Choice D, 'decreased cortisol levels,' is also incorrect as cortisol and testosterone are regulated by separate endocrine pathways.

4. Which of the following steps occurs first during hemostasis?

• A. Vascular spasm
• B. Platelet plug
• C. Coagulation
• D. Dissolution of the clot

Correct answer: A

Rationale: Vascular spasm is the initial step in hemostasis, where blood vessels constrict to reduce blood flow to the injured area. This constriction helps limit blood loss until further steps like platelet plug formation and coagulation can take place. Platelet plug formation and coagulation occur after the vascular spasm, making them incorrect choices. Dissolution of the clot happens much later in the healing process, after the injury has sufficiently healed.

5. A patient who is being administered isoniazid (INH) for tuberculosis has a yellow color in the sclera of her eye. What other finding would lead you to believe that hepatotoxicity has developed?

• A. Diarrhea
• B. Numbness
• C. Diminished vision
• D. Light-colored stools

Correct answer: A

Rationale: The correct answer is A: Diarrhea. Hepatotoxicity caused by isoniazid can present with various symptoms, including yellow discoloration of the sclera of the eyes, which indicates jaundice. Another common sign of hepatotoxicity is gastrointestinal symptoms such as nausea, vomiting, and diarrhea, which can occur due to liver dysfunction affecting bile production and digestion. Numbness (choice B) is more commonly associated with peripheral neuropathy caused by isoniazid, while diminished vision (choice C) and light-colored stools (choice D) are not typical manifestations of hepatotoxicity.

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