Nursing Elites

1. A healthcare professional is assessing a client with suspected myasthenia gravis. Which symptom would the healthcare professional expect to find?

• A. Muscle atrophy
• B. Facial weakness
• C. Ptosis and diplopia
• D. Increased muscle tone

Correct answer: C

Rationale: Ptosis (drooping eyelid) and diplopia (double vision) are classic symptoms of myasthenia gravis. Muscle atrophy (Choice A) is not a typical early manifestation of myasthenia gravis. While facial weakness (Choice B) can occur, it is not as specific as ptosis and diplopia. Increased muscle tone (Choice D) is more indicative of conditions like spasticity, not myasthenia gravis.

2. In which patient is alpha-1 antitrypsin deficiency the likely cause of chronic obstructive pulmonary disease?

• A. A 30-year-old who has smoked for 3 years
• B. A 65-year-old man who worked as a taxi driver most of his life
• C. A 70-year-old woman who smoked for 40 years
• D. A 50-year-old with exposure to secondhand smoke

Correct answer: A

Rationale: The correct answer is A. Alpha-1 antitrypsin deficiency is a genetic condition that can lead to COPD at a young age, even in light smokers. Choice B is less likely as the patient's occupation does not directly correlate with alpha-1 antitrypsin deficiency. Choice C, a 70-year-old woman with a long smoking history, is more likely to have COPD due to smoking rather than alpha-1 antitrypsin deficiency. Choice D, exposure to secondhand smoke, is not a common cause of alpha-1 antitrypsin deficiency-related COPD.

3. When the body produces antibodies against its own tissue, the condition is called:

• A. Alloimmunity
• B. Opsonization
• C. Autoimmunity
• D. Hypersensitivity

Correct answer: C

Rationale: Autoimmunity is the correct term for a condition where the body's immune system mistakenly targets its own tissues. Alloimmunity (Choice A) refers to an immune response against foreign tissue. Opsonization (Choice B) is a process where pathogens are marked for destruction by immune cells. Hypersensitivity (Choice D) involves an exaggerated immune response against antigens.

4. 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.

5. During admission, 82-year-old Mr. Robeson is brought to the medical-surgical unit for diagnostic confirmation and management of probable delirium. Which statement by the client’s daughter best supports the diagnosis?

• A. “Maybe it’s just caused by aging. This usually happens by age 82.”
• B. “The changes in his behavior came on so quickly! I wasn’t sure what was happening.”
• C. “Dad just didn’t seem to know what he was doing. He would forget what he had for breakfast.”
• D. “Dad has always been so independent. He’s lived alone for years since mom died.”

Correct answer: B

Rationale: The correct answer is B because sudden onset of behavioral changes is a typical symptom of delirium. Delirium is characterized by an acute and fluctuating disturbance in attention, awareness, and cognition. Choice A is incorrect because delirium is not a normal part of aging. Choice C describes memory issues, which can be seen in delirium but are less specific than sudden behavioral changes. Choice D, while it mentions the patient's independence, does not directly support the diagnosis of delirium.

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