Nursing Elites

1. A patient is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the main rationale for administering these medications together?

• A. They improve treatment adherence.
• B. They reduce the duration of illness.
• C. They exhibit synergistic antiviral effects.
• D. They prevent opportunistic infections.

Correct answer: C

Rationale: The main rationale for administering a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor is that they exhibit synergistic antiviral effects when used together. This combination enhances their antiviral activity against HIV by targeting different steps in the viral replication cycle. Choice A is incorrect because the rationale for combining these medications is based on their antiviral effects, not treatment adherence. Choice B is incorrect because the primary purpose of combination therapy is not to reduce the duration of illness but to improve treatment efficacy. Choice D is incorrect as the main focus of this combination is not on preventing opportunistic infections but on directly targeting the HIV virus.

2. The early stages of atheroma development are characterized by:

• A. macrophages full of oxidized low-density lipoprotein (LDL; i.e., foam cells) in the intima
• B. accumulation of lipids in the intima (i.e., fatty streak)
• C. accumulation of proteins such as collagen and elastin (i.e., fibrous cap)
• D. development of calcium and a necrotic lipid core

Correct answer: A

Rationale: The correct answer is A. In the early stages of atheroma development, macrophages accumulate oxidized low-density lipoprotein (LDL) and transform into foam cells, leading to the formation of fatty streaks in the intima of blood vessels. This process is a hallmark of the initial stages of atherosclerosis. Choice B is incorrect as it describes the accumulation of lipids in the intima, which is a later event following foam cell formation. Choice C is also incorrect as it refers to the accumulation of proteins forming the fibrous cap, which occurs at a later stage to stabilize the atheroma. Choice D is incorrect as it describes the development of calcium and a necrotic lipid core, typically seen in advanced atherosclerosis rather than the early stages.

3. A 45-year-old woman presents with fatigue, weight gain, and cold intolerance. Her thyroid function tests reveal low T3 and T4 levels and elevated TSH levels. Which of the following is the most likely diagnosis?

• A. Hyperthyroidism
• B. Hypothyroidism
• C. Euthyroid sick syndrome
• D. Subclinical hyperthyroidism

Correct answer: B

Rationale: The scenario describes a 45-year-old woman with fatigue, weight gain, cold intolerance, low T3 and T4 levels, and elevated TSH levels, which are indicative of hypothyroidism. In hypothyroidism, there is decreased production of thyroid hormones (T3 and T4) leading to elevated TSH levels as the pituitary gland tries to stimulate the thyroid gland to produce more hormones. Therefore, the correct answer is hypothyroidism (Choice B). Choice A, Hyperthyroidism, is incorrect as the patient's symptoms and thyroid function tests point towards decreased thyroid hormone levels, which is characteristic of hypothyroidism, not hyperthyroidism. Choice C, Euthyroid sick syndrome, is incorrect because this condition typically presents with normal to low T3 and T4 levels in the setting of non-thyroid illness, unlike the elevated TSH levels observed in this case. Choice D, Subclinical hyperthyroidism, is also incorrect as the patient has low T3 and T4 levels, which is not consistent with hyperthyroidism, whether clinical or subclinical.

4. Which of the following chronic inflammatory skin disorders is characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation?

• A. Psoriasis
• B. Melanoma
• C. Atopic dermatitis
• D. Urticaria

Correct answer: A

Rationale: Psoriasis is the correct answer. Psoriasis is a chronic inflammatory skin disorder characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation. Choice B, Melanoma, is a type of skin cancer involving melanocytes, not characterized by the features mentioned. Choice C, Atopic dermatitis, is a different inflammatory skin condition associated with pruritus and eczematous lesions, not primarily characterized by angiogenesis. Choice D, Urticaria, is a skin condition characterized by hives and wheals due to histamine release, not typically involving the features mentioned in the question.

5. After a generalized seizure, a 27-year-old woman with epilepsy feels tired and falls asleep. This is:

• A. an ominous sign.
• B. normal and termed the postictal period.
• C. a reflection of an underlying brain tumor.
• D. only worrisome if there are focal neurologic deficits after.

Correct answer: B

Rationale: Choice B is the correct answer. The postictal period is the phase following a seizure, characterized by symptoms like fatigue, confusion, and sleepiness. It is a normal part of the seizure process and does not necessarily indicate a serious underlying issue. Choice A is incorrect because feeling tired and falling asleep after a seizure is expected and not an ominous sign. Choice C is incorrect as there is no indication in the scenario provided to suggest an underlying brain tumor. Choice D is incorrect because the presence of focal neurologic deficits would indeed be concerning, but the postictal state itself is a common and expected occurrence post-seizure.

Similar Questions