Nursing Elites

1. What is the action of amphotericin B?

• A. It binds to ergosterol and forms holes in the membrane.
• B. It binds to an enzyme required for the synthesis of ergosterol.
• C. It disrupts the fungal cell walls rather than the cell membrane.
• D. It inhibits glucan synthetase required for glucan synthesis.

Correct answer: A

Rationale: Amphotericin B is an antifungal medication that acts by binding to ergosterol, a component of fungal cell membranes, forming pores that disrupt the integrity of the membrane. This action leads to leakage of cellular contents and ultimately cell death. Choice B is incorrect as amphotericin B does not bind to an enzyme required for the synthesis of ergosterol. Choice C is incorrect as the drug primarily affects the cell membrane rather than the cell wall. Choice D is also incorrect as amphotericin B does not inhibit glucan synthetase.

2. During a well-child checkup, a mother tells Nurse Rio about a recent situation in which her child needed to be disciplined by her husband. The child was slapped in the face for not getting her husband breakfast on Saturday, despite being told on Thursday never to prepare food for him. Nurse Rio analyzes the family system and concludes it is dysfunctional. All of the following factors contribute to this dysfunction except:

• A. Conflictual relationships between parents.
• B. Inconsistent communication patterns.
• C. Rigid, authoritarian roles.
• D. Use of violence to establish control.

Correct answer: C

Rationale: In a dysfunctional family system, conflictual relationships, inconsistent communication patterns, and the use of violence to establish control are factors contributing to dysfunction. However, rigid, authoritarian roles, though also dysfunctional, are not directly linked to the use of violence for control.

3. A client with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days after the amputation, the client confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can:

• A. administer a psychotropic medication to help the client cope with the sensation of his amputated leg.
• B. explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site.
• C. call the physician and request an order for a psychological consult.
• D. educate the client that this area has an unusually abnormal increase in sensitivity to sensation but that it will go away with time.

Correct answer: B

Rationale: The correct answer is B. The sensation of feeling the amputated limb is known as phantom limb pain, which is common after amputation. One theory suggests that it occurs because the end of a regenerating nerve becomes trapped in the scar tissue at the amputation site. Administering psychotropic medication (choice A) is not the first-line treatment for phantom limb pain. Requesting a psychological consult (choice C) is premature without first addressing the known pathophysiological basis of phantom limb pain. Educating the client that the sensitivity will go away with time (choice D) is not entirely accurate as phantom limb pain can persist long-term.

4. A 22-year-old woman began using oral contraceptives several months ago and has presented for an appointment to discuss recent worrisome changes in her health status. Which of the following changes in the woman's health may the nurse potentially attribute to the use of oral contraceptives?

• A. Fatigue
• B. Frequent high blood pressure readings
• C. Frequent headaches without aura
• D. Nausea and vomiting

Correct answer: A

Rationale: The correct answer is A: Fatigue. Oral contraceptives can sometimes cause fatigue as a side effect. Frequent high blood pressure readings and frequent headaches without aura are less likely to be directly related to the use of oral contraceptives. Nausea and vomiting are common side effects of oral contraceptives but are not the changes typically associated with liver function affecting hormone metabolism as in the case of hepatitis C infection.

5. A patient is being administered chemotherapeutic agents for the treatment of cancer. Which of the following blood cells will be stimulated by the colony-stimulating factors in response to the effects of the chemotherapy?

• A. White blood cells
• B. Red blood cells
• C. Phagocytes
• D. Myocardial cells

Correct answer: A

Rationale: The correct answer is White blood cells. Colony-stimulating factors stimulate the production of white blood cells in response to the effects of chemotherapy, as it can lead to myelosuppression. Red blood cells are not directly stimulated by colony-stimulating factors. Phagocytes are a type of white blood cell involved in immune responses, but they are not specifically stimulated by colony-stimulating factors. Myocardial cells are cardiac muscle cells and are not directly involved in the response to chemotherapy-induced myelosuppression.

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