Nursing Elites

1. A nursing student having trouble moving her head from side to side is likely experiencing a problem with which type of neurons?

• A. General visceral efferent neurons
• B. Preganglionic neurons
• C. Parasympathetic postganglionic neurons
• D. Pharyngeal efferent neurons

Correct answer: D

Rationale: The correct answer is D: Pharyngeal efferent neurons. Pharyngeal efferent neurons are responsible for controlling head movements, including side-to-side motions. General visceral efferent neurons (Choice A) are involved in innervating smooth muscles and glands in the body's internal organs. Preganglionic neurons (Choice B) are part of the autonomic nervous system and connect the central nervous system to the ganglia. Parasympathetic postganglionic neurons (Choice C) are the second neurons in the parasympathetic nervous system pathway, responsible for innervating target organs. In this case, the issue with moving the head from side to side indicates a problem with the pharyngeal efferent neurons.

2. What specific instructions should the nurse provide for proper administration of alendronate (Fosamax) in a patient with osteoporosis?

• A. Take the medication with milk to enhance calcium absorption.
• B. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: B

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper drug absorption. Choice A is incorrect as alendronate should not be taken with milk due to potential interactions. Choice C is incorrect as there is no need to take the medication at bedtime specifically. Choice D is incorrect as taking alendronate with food can decrease its absorption.

3. A patient is prescribed finasteride (Proscar) for benign prostatic hyperplasia (BPH). What outcome should the nurse expect to observe?

• A. Decreased urinary frequency and urgency
• B. Increased prostate size
• C. Increased blood pressure
• D. Increased risk of kidney stones

Correct answer: A

Rationale: The correct answer is A: Decreased urinary frequency and urgency. Finasteride is expected to decrease urinary frequency and urgency in patients with BPH by reducing prostate size. It works by inhibiting the enzyme that converts testosterone to dihydrotestosterone, which helps shrink the prostate gland. Choices B, C, and D are incorrect. Finasteride does not increase prostate size, blood pressure, or the risk of kidney stones.

4. Which of the following is a cause of hypothyroidism?

• A. Overproduction of cortisol
• B. Autoimmune destruction of the thyroid gland
• C. Overactivity of the thyroid gland
• D. Insufficient iodine intake

Correct answer: B

Rationale: The correct answer is B: Autoimmune destruction of the thyroid gland. In hypothyroidism, the thyroid gland does not produce enough hormones to meet the body's needs. This can be due to autoimmune destruction of the thyroid gland, where the body's immune system mistakenly attacks the thyroid tissue. Choices A, C, and D are incorrect. Overproduction of cortisol is associated with conditions like Cushing's syndrome, overactivity of the thyroid gland is a characteristic of hyperthyroidism, and insufficient iodine intake can lead to goiter but not necessarily hypothyroidism.

5. Following the administration of her annual influenza vaccination, a health care worker remains at the clinic for observation due to pain at the injection site. What should the nurse recommend?

• A. ASA
• B. Acetaminophen
• C. Meperidine (Demerol)
• D. Heat application

Correct answer: B

Rationale: The correct recommendation for pain at the injection site after an influenza vaccination is Acetaminophen. Acetaminophen is a suitable choice for managing mild to moderate pain and fever commonly associated with vaccinations. Choice A, ASA (aspirin), is not recommended due to the risk of Reye's syndrome in children and teenagers following viral illnesses. Choice C, Meperidine (Demerol), is a potent opioid analgesic and is not typically indicated for mild pain relief. Choice D, heat application, is not the standard recommendation for pain at an injection site and may not provide adequate relief.

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