Nursing Elites

1. A client with heart failure is experiencing pulmonary edema. Which intervention should be prioritized?

• A. Administer diuretics to reduce fluid overload.
• B. Position the client in high-Fowler's position.
• C. Administer oxygen therapy to improve oxygenation.
• D. Restrict fluid intake to prevent further fluid overload.

Correct answer: C

Rationale: In a client experiencing pulmonary edema due to heart failure, the priority intervention is to administer oxygen therapy to improve oxygenation. This helps in increasing the oxygen levels in the blood, thereby improving tissue perfusion and reducing the workload on the heart. Positioning the client in high-Fowler's position can also aid in improving oxygenation, but administering oxygen therapy directly addresses the immediate need for increased oxygen levels. Administering diuretics to reduce fluid overload and restricting fluid intake are important interventions in heart failure management, but in the acute situation of pulmonary edema, oxygen therapy takes precedence to ensure adequate oxygen supply to vital organs.

2. A patient develops itching and burning of the vaginal vault while taking an anti-infective to treat strep throat. What fungal agent has most likely caused the burning and itching?

• A. Cryptococcus neoformans
• B. Candida albicans
• C. Aspergillus
• D. Dermatophytes

Correct answer: B

Rationale: The correct answer is B: Candida albicans. Candida albicans is a common fungal agent responsible for causing vaginal yeast infections characterized by itching and burning. It is known to overgrow in the vagina, especially when the normal vaginal flora is disrupted, such as during antibiotic use. Cryptococcus neoformans is more associated with causing meningitis in immunocompromised individuals, not vaginal symptoms. Aspergillus is more commonly associated with lung infections and allergic reactions, not vaginal infections. Dermatophytes typically cause skin infections like ringworm, not vaginal symptoms.

3. When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is:

• A. positively charged.
• B. inhibitory.
• C. overstimulated.
• D. dormant.

Correct answer: B

Rationale: Acetylcholine acts as an inhibitory neurotransmitter at the sinoatrial node. It slows down the heart rate by decreasing the firing rate of the sinoatrial node, which serves as the heart's natural pacemaker. Neurotransmitters do not have a charge, so choice A is incorrect. Choice C is wrong as overstimulation is not a characteristic of acetylcholine at the sinoatrial node. Choice D is also incorrect because acetylcholine actively influences heart rate regulation when released at the sinoatrial node.

4. A patient arrives at her follow-up appointment 1 month post-hysterectomy and complains to the nurse that her scars do not seem to be healing properly. Upon inspection, the nurse notices that the scars are raised but still within the boundaries of the original incisions. The nurse tells the patient this kind of dysfunctional wound healing is called:

• A. Hypertrophic scarring
• B. Dehiscence
• C. Contracture
• D. A keloid

Correct answer: A

Rationale: Hypertrophic scarring occurs when a scar is raised but remains within the boundaries of the original wound, unlike keloids, which extend beyond the wound edges. Dehiscence refers to the separation of wound edges, while contracture involves the tightening or constriction of a scar, leading to limited mobility.

5. What causes atherosclerotic plaques to form initially?

• A. Interruption of blood flow to the brain
• B. Injury to the coronary artery endothelium
• C. Administration of statin medications
• D. Poor dietary modifications

Correct answer: B

Rationale: Atherosclerotic plaques form initially due to injury to the coronary artery endothelium, which triggers a cascade of events leading to plaque buildup. Choice A is incorrect because atherosclerotic plaques do not form due to an interruption of blood flow to the brain. Choice C is incorrect as statin medications are actually used to help lower cholesterol and reduce the risk of plaque formation. Choice D is incorrect as poor dietary modifications can contribute to atherosclerosis but are not the initial cause of plaque formation.

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