Nursing Elites

1. How often should a patient be administered a tetanus toxoid?

• A. Every year
• B. Every 10 years
• C. Every 2 years
• D. Every 5 years

Correct answer: B

Rationale: Tetanus toxoid should be administered every 10 years to ensure continued protection against tetanus infection. The correct answer is 'Every 10 years.' Choice A ('Every year') is incorrect as the frequency is too frequent. Choice C ('Every 2 years') is incorrect as it is too frequent for tetanus toxoid administration. Choice D ('Every 5 years') is incorrect as it does not align with the recommended interval for tetanus toxoid booster doses.

2. The unique clinical presentation of a 3-month-old infant in the emergency department leads the care team to suspect botulism. Which assessment question posed to the parents is likely to be most useful in the differential diagnosis?

• A. Have you ever given your child any honey or honey-containing products?
• B. Is there any family history of neuromuscular diseases?
• C. Has your baby ever been directly exposed to any chemical cleaning products?
• D. Is there any mold in your home that you know of?

Correct answer: A

Rationale: The correct answer is A. Botulism in infants is often linked to honey consumption. Asking the parents if they have ever given their child any honey or honey-containing products can provide crucial information for the differential diagnosis. This is important because infant botulism is commonly associated with the ingestion of honey contaminated with Clostridium botulinum spores. Choices B, C, and D are less relevant to botulism in infants as they do not directly relate to the typical causes of the condition. Family history of neuromuscular diseases (choice B) may be important for other conditions but not specifically for infant botulism. Direct exposure to chemical cleaning products (choice C) and the presence of mold in the home (choice D) are not typical risk factors for infant botulism.

3. Which of the following are risk factors for hypertension (HTN)?

• A. High sugar, low-fat diet
• B. Increased physical activity
• C. Tobacco use
• D. Low-fat diet

Correct answer: C

Rationale: Tobacco use is a well-established risk factor for hypertension (HTN) as it can lead to increased blood pressure. High sugar intake and low-fat diets, as well as increased physical activity, are not directly associated with hypertension. While low-fat diets are generally recommended for overall health, they are not specifically linked to hypertension risk.

4. In Guillain-Barre syndrome, what pathophysiologic process underlies the deficits that accompany the degeneration of myelin in the peripheral nervous system (PNS)?

• A. The destruction of myelin results in a reduction in Schwann cell production in the client's PNS.
• B. The lack of myelin surrounding nerve cells compromises the axonal transport system.
• C. Without remyelination, the axon will eventually die.
• D. A deficit of myelin makes the client more susceptible to infection by potential pathogens.

Correct answer: C

Rationale: In Guillain-Barre syndrome, the destruction of myelin leads to axonal damage. If remyelination does not occur, the axon will eventually degenerate and die, impacting nerve function. Choice A is incorrect because the destruction of myelin does not affect Schwann cell production. Choice B is incorrect as the lack of myelin directly affects the conduction of nerve impulses, not the axonal transport system. Choice D is incorrect as a deficit of myelin does not predispose the client to infections by potential pathogens.

5. A patient is being treated with raloxifene (Evista) for osteoporosis. What should the nurse teach the patient about this medication?

• A. It is used as a selective estrogen receptor modulator to prevent bone loss.
• B. It works by decreasing bone formation and increasing bone resorption.
• C. It should be taken with food to reduce gastrointestinal side effects.
• D. It may cause weight gain and fluid retention.

Correct answer: C

Rationale: The correct answer is C. Raloxifene is a selective estrogen receptor modulator (SERM) used to prevent bone loss. It should be taken with food to reduce gastrointestinal side effects, not on an empty stomach. Choices A and B are incorrect because raloxifene is indeed a SERM that prevents bone loss, but it does not directly work by increasing bone formation or decreasing bone resorption. Choice D is incorrect as weight gain and fluid retention are not common side effects of raloxifene.

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