Nursing Elites

1. Why is a beta-blocker prescribed to a client with a history of myocardial infarction?

• A. To reduce myocardial oxygen demand.
• B. To increase cardiac output.
• C. To prevent arrhythmias.
• D. To prevent the development of angina.

Correct answer: A

Rationale: The primary reason for administering a beta-blocker to a client with a history of myocardial infarction is to reduce myocardial oxygen demand. By reducing myocardial oxygen demand, beta-blockers help decrease the workload on the heart, making it easier for the heart to function effectively. This is crucial for clients with a history of myocardial infarction to prevent further damage to the heart. Choice B is incorrect because beta-blockers do not aim to increase cardiac output; instead, they help improve cardiac function by reducing workload. Choice C is incorrect because while beta-blockers can help prevent certain arrhythmias, the primary reason for their use in this case is to reduce myocardial oxygen demand. Choice D is incorrect as preventing angina is not the primary purpose of administering beta-blockers to a client with a history of myocardial infarction.

2. The nurse is caring for a client with an astrocytoma. The client asks, 'What do astrocytes do in the brain?' What is the nurse's best response?

• A. Astrocytes help to nourish and support neurons in the brain.
• B. Astrocytes are a type of neuron that transmit electrical signals.
• C. Astrocytes are involved in immune responses in the brain.
• D. Astrocytes help regulate blood flow in the brain.

Correct answer: A

Rationale: Astrocytes play a crucial role in supporting and nourishing neurons by providing metabolic support, maintaining the blood-brain barrier, and regulating the chemical environment of the brain. While astrocytes are essential for brain function, they are not neurons and do not transmit electrical signals (Choice B). Astrocytes are not primarily involved in immune responses in the brain (Choice C) or in regulating blood flow in the brain (Choice D), although they indirectly influence blood flow through their support functions.

3. In addition to matching ABO antigens, a blood transfusion must also be matched for:

• A. HLA type
• B. Rh antigen
• C. Immunoglobulins
• D. Platelet compatibility

Correct answer: B

Rationale: The correct answer is B: Rh antigen. In addition to ABO antigens, Rh antigen must also be matched for a blood transfusion. Rh antigen compatibility is crucial to prevent adverse reactions. Choice A, HLA type, is not directly related to blood transfusions but plays a role in organ transplantation. Choice C, Immunoglobulins, are not typically matched for blood transfusions. Choice D, Platelet compatibility, while important in specific cases, is not a standard requirement for all blood transfusions.

4. A patient taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which of the following is most important?

• A. Begin an exercise regimen.
• B. Begin smoking cessation.
• C. Begin daily aspirin therapy.
• D. Begin taking a loop diuretic to aid weight loss.

Correct answer: B

Rationale: The most important action for a patient taking hormonal contraceptives, who is nearing 35 years of age, moderately obese, and has a history of smoking for 15 years, is to begin smoking cessation. Women over 35, especially smokers, are at an increased risk of blood clots and cardiovascular issues when using hormonal contraceptives. Smoking cessation is crucial to reduce this risk. Beginning an exercise regimen may be beneficial for overall health but is not as critical as stopping smoking in this scenario. Daily aspirin therapy or taking a loop diuretic are not indicated in this situation and may not address the primary risk associated with hormonal contraceptives and smoking.

5. In emphysema, what features result in impaired oxygenation?

• A. The bronchioles are inflamed and filled with mucus
• B. The alveoli have lost surfactant and collapse
• C. Enlarged, permanently inflated alveoli
• D. The accumulation of purulent fluid in the bronchioles

Correct answer: C

Rationale: The correct answer is C. In emphysema, impaired oxygenation results from enlarged and permanently inflated alveoli, leading to reduced surface area for gas exchange. Choices A, B, and D are incorrect. In emphysema, bronchioles are not typically filled with mucus, alveoli losing surfactant and collapsing is more characteristic of conditions like atelectasis, and purulent fluid accumulation in the bronchioles is commonly seen in conditions like pneumonia, not emphysema.

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