Nursing Elites

1. A patient has a heart attack that leads to progressive cell injury resulting in cell death with severe cell swelling and breakdown of organelles. What term would the nurse use to define this process?

• A. Adaptation
• B. Pathologic calcification
• C. Apoptosis
• D. Necrosis

Correct answer: D

Rationale: The correct answer is D: Necrosis. Necrosis is the process of cell death characterized by cell swelling, breakdown of organelles, and eventual rupture, often following ischemic injury like a heart attack. Choices A, B, and C are incorrect. Adaptation refers to the ability of cells to adjust to changes in their environment. Pathologic calcification is the abnormal deposition of calcium salts in tissues. Apoptosis is a programmed cell death that occurs in a controlled, orderly manner.

2. What condition can be caused by an excessive amount of growth hormone released by the pituitary gland in childhood?

• A. Acromegaly
• B. Gigantism
• C. Syndrome of inappropriate antidiuretic hormone
• D. Dwarfism

Correct answer: B

Rationale: Gigantism is the correct answer. It is a condition caused by excessive growth hormone release before the epiphyseal plates close, leading to abnormal growth. Acromegaly (choice A) is caused by excess growth hormone after the epiphyseal plates close, resulting in enlargement of bones and tissues. Syndrome of inappropriate antidiuretic hormone (choice C) is characterized by the excessive release of antidiuretic hormone, leading to water retention and dilutional hyponatremia. Dwarfism (choice D) is a condition characterized by significantly below-average height.

3. What is the primary function of the kidneys in acid-base balance?

• A. The kidneys remove hydrogen ions and retain bicarbonate ions.
• B. The kidneys convert ammonia into urea, which is excreted in the urine.
• C. The kidneys produce aldosterone to regulate sodium levels.
• D. The kidneys secrete renin to regulate blood pressure.

Correct answer: A

Rationale: The correct answer is A. The kidneys are crucial in maintaining acid-base balance by removing hydrogen ions to decrease acidity and retaining bicarbonate ions to increase alkalinity. Choice B is incorrect because the conversion of ammonia into urea is related to nitrogen waste excretion, not acid-base balance. Choice C is incorrect as aldosterone regulates sodium levels, not acid-base balance. Choice D is also incorrect as renin is involved in regulating blood pressure, not acid-base balance.

4. Which of the following describes passive immunity?

• A. Vaccination against the disease
• B. Transfer of antibodies from mother to baby
• C. Cuts or wounds that are infected and heal
• D. Having the disease in question

Correct answer: B

Rationale: Passive immunity is the transfer of pre-formed antibodies from one individual to another, providing immediate but temporary protection. In this case, the correct answer is the transfer of antibodies from the mother to the baby, as it describes the concept of passive immunity. Choice A, vaccination against the disease, refers to active immunity where the individual's immune system is stimulated to produce antibodies. Choice C, cuts or wounds that are infected and heal, is unrelated to immunity. Choice D, having the disease in question, does not describe passive immunity but rather acquiring active immunity through exposure to the pathogen.

5. A 60-year-old male client with a long history of back pain has had little success with a variety of analgesic regimens that his family physician has prescribed. He has recently been diagnosed with a chronic pain disorder. Which teaching points about chronic pain would his physician most likely emphasize to the client?

• A. Chronic pain is often difficult to treat and requires a multimodal approach.
• B. Chronic pain indicates that an underlying injury has not healed properly.
• C. Chronic pain can be managed with a single long-term medication.
• D. Chronic pain is typically less severe than acute pain but lasts longer.

Correct answer: A

Rationale: The correct answer is A. Chronic pain is often complex and challenging to treat, necessitating a multimodal approach that may include medication, physical therapy, and behavioral therapy. Choice B is incorrect because chronic pain does not always indicate that an underlying injury has not healed properly; it can persist even after the initial injury has healed. Choice C is incorrect as chronic pain management usually involves a combination of treatments rather than relying solely on a single long-term medication. Choice D is incorrect because chronic pain is not necessarily less severe than acute pain; it can vary in intensity and duration depending on the individual and underlying condition.

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