Nursing Elites

1. A patient is diagnosed with type 2 diabetes mellitus. Which of the following is a common initial treatment strategy?

• A. Insulin therapy
• B. Lifestyle modification and metformin
• C. Sulfonylureas
• D. Thiazolidinediones

Correct answer: B

Rationale: The correct answer is B: Lifestyle modification and metformin. When managing type 2 diabetes mellitus, initial treatment often involves lifestyle changes such as adopting a healthy diet and increasing physical activity, along with the oral medication metformin. Insulin therapy (choice A) is usually reserved for cases where lifestyle changes and oral medications are not sufficient to control blood sugar levels. Sulfonylureas (choice C) and thiazolidinediones (choice D) are also oral medications used in diabetes management, but they are not typically recommended as first-line treatments due to various side effects and considerations in type 2 diabetes management.

2. A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What important instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain.
• B. Avoid consuming grapefruit juice while taking this medication.
• C. Take the medication in the morning with breakfast.
• D. Avoid taking the medication with alcohol to reduce the risk of liver damage.

Correct answer: A

Rationale: The correct answer is A. Atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking it at night aligns with the body's natural rhythm of cholesterol production, optimizing its effectiveness. Choice B is incorrect because grapefruit juice can increase the risk of side effects by affecting the metabolism of atorvastatin. Choice C is incorrect as taking atorvastatin in the morning does not maximize its effectiveness. Choice D is incorrect because alcohol consumption can increase the risk of liver damage when combined with atorvastatin.

3. Muscular dystrophy is a result of an abnormality of the muscle protein:

• A. glycoprotein
• B. dystrophin
• C. troponin
• D. actinomyosin

Correct answer: B

Rationale: Muscular dystrophy is primarily caused by mutations in the gene that provides instructions for making the protein dystrophin. Dystrophin plays a crucial role in maintaining the structure of muscle fibers. Glycoprotein is a general term for proteins with sugar molecules attached, not specifically related to muscular dystrophy. Troponin is a protein involved in muscle contraction regulation, and actinomyosin is not a specific muscle protein but a complex formed during muscle contraction. Therefore, the correct answer is dystrophin.

4. What type of immunity will the hepatitis B series provide a nursing student scheduled to receive it?

• A. Active immunity
• B. Passive immunity
• C. Innate immunity
• D. Natural immunity

Correct answer: A

Rationale: The correct answer is active immunity. The hepatitis B series immunization will provide active immunity, where the individual's immune system is stimulated to produce antibodies against the hepatitis B virus. This type of immunity is long-lasting and provides protection against future exposures. Passive immunity (choice B) involves the transfer of pre-formed antibodies and is temporary. Innate immunity (choice C) is the body's natural defense mechanisms, present at birth. Natural immunity (choice D) refers to immunity acquired through normal life processes, such as recovering from an infection.

5. What is the best method to identify which type of stroke the client has?

• A. Obtain a 12-lead electrocardiogram STAT
• B. Obtain a blood specimen for electrolytes and blood cultures
• C. Ask the client about current allergies
• D. Obtain a cranial computerized tomogram (CT) STAT

Correct answer: D

Rationale: The correct answer is to obtain a cranial computerized tomogram (CT) STAT. A cranial CT scan is the best method to quickly identify the type of stroke a client is experiencing. Options A, B, and C are not appropriate for identifying the type of stroke as they are not specific to assessing stroke types.

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