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. A client with a history of tuberculosis (TB) is experiencing a recurrence of symptoms. Which diagnostic test should the nurse anticipate being ordered?

• A. Sputum culture
• B. Bronchoscopy
• C. Chest x-ray
• D. CT scan of the chest

Correct answer: C

Rationale: A chest x-ray is the most appropriate diagnostic test for a client with a history of tuberculosis experiencing a recurrence of symptoms. A chest x-ray is commonly used to visualize the lungs and check for signs of active tuberculosis, such as abnormal shadows or nodules. While a sputum culture (Choice A) can confirm the presence of TB bacteria, it may not be the initial test ordered for a recurrence. Bronchoscopy (Choice B) and CT scan of the chest (Choice D) are more invasive and usually reserved for cases where the chest x-ray is inconclusive or to further assess complications, rather than as the initial diagnostic test for a recurrence of tuberculosis.

3. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What is a key contraindication that the nurse should review with the patient?

• A. History of hypertension
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of peptic ulcer disease

Correct answer: B

Rationale: The correct answer is B: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both act as vasodilators, and their combined use can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because having a history of hypertension, using antihypertensive medications, or having a history of peptic ulcer disease are not key contraindications for sildenafil use.

4. An imbalance of which of the following hormones could lead to increased calcium levels in the blood?

• A. Parathyroid hormone
• B. Antidiuretic hormone
• C. Calcitonin
• D. Melatonin

Correct answer: A

Rationale: The correct answer is Parathyroid hormone (Choice A). Parathyroid hormone plays a key role in regulating calcium levels in the blood. When there is an imbalance in parathyroid hormone secretion, it can lead to increased calcium levels in the blood. Antidiuretic hormone (Choice B) is involved in regulating water balance, not calcium levels. Calcitonin (Choice C) helps lower blood calcium levels and is unlikely to cause an increase. Melatonin (Choice D) regulates sleep-wake cycles and does not have a direct effect on calcium levels in the blood.

5. While planning care for an elderly patient, the nurse remembers that increased age is associated with:

• A. Increased T cell function
• B. Increased immune function
• C. Increased production of antibodies
• D. Increased levels of circulating autoantibodies

Correct answer: D

Rationale: As individuals age, their immune function tends to decrease, making them more susceptible to infections and diseases. Additionally, increased age is associated with higher levels of circulating autoantibodies, which can lead to autoimmune conditions. Choice A is incorrect as aging is not typically associated with increased T cell function. Choice C is also incorrect as aging does not necessarily result in increased production of antibodies. Therefore, the correct answers are B (Decreased immune function) and D (Increased levels of circulating autoantibodies).

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