Nursing Elites

1. A patient presents with a rash from poison ivy. The nurse knows that this is which type of hypersensitivity?

• A. Type I
• B. Type II
• C. Type III
• D. Type IV

Correct answer: D

Rationale: A rash from poison ivy is an example of a type IV hypersensitivity reaction. Type IV hypersensitivity reactions are delayed cell-mediated immune responses involving T cells. This type of reaction is characterized by a delayed onset, typically occurring 48-72 hours after exposure to the antigen. Choice A, Type I hypersensitivity reactions, are immediate hypersensitivity reactions mediated by IgE antibodies. Choices B and C, Type II and Type III hypersensitivity reactions, involve antibody-mediated cytotoxicity and immune complex deposition, respectively, which are not characteristic of poison ivy-induced rashes.

2. Which of the following disturbances would cause a client to experience gout?

• A. Serotonin receptors
• B. Uric acid metabolism
• C. Liver function
• D. Cardiac function

Correct answer: B

Rationale: Gout is caused by a disturbance in uric acid metabolism, leading to the accumulation of uric acid crystals in joints. Serotonin receptors (Choice A) are not related to gout. Liver function (Choice C) is important for metabolism but is not directly linked to gout development. Cardiac function (Choice D) is primarily related to the heart's functioning and not associated with gout.

3. Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias?

• A. Vitamin B12
• B. Folate
• C. Iron
• D. Vitamin K

Correct answer: Vitamin B12

Rationale: The correct answer is Vitamin B12. Vitamin B12 deficiency can lead to megaloblastic anemia, a condition characterized by the production of abnormally large and immature red blood cells. Lower extremity paresthesias, such as tingling or numbness, are common neurological symptoms associated with vitamin B12 deficiency. Folate deficiency can also cause megaloblastic anemia but is not typically linked to lower extremity paresthesias. Iron deficiency leads to microcytic anemia, not megaloblastic anemia. Vitamin K deficiency is associated with bleeding tendencies, not megaloblastic anemia or paresthesias.

4. In which patients would the manifestation of a headache be a sign of a serious underlying disorder?

• A. A 55-year-old man with new onset of headaches that are worse at night and reported mood swings according to his family
• B. A 30-year-old woman with a unilateral throbbing headache with photophobia and nausea
• C. A 60-year-old man with his head feeling full and throbbing and muscle aching around his neck and shoulders
• D. A 40-year-old woman who experiences food cravings, gets irritable, and then develops a pulsatile-like headache on the right side of her head

Correct answer: A 55-year-old man with new onset of headaches that are worse at night and reported mood swings according to his family

Rationale: In this scenario, the correct answer is the 55-year-old man with new onset headaches that worsen at night and reported mood swings according to his family. These symptoms, especially when combined with nighttime worsening and mood changes, could indicate a serious underlying disorder such as a brain tumor or increased intracranial pressure. Choice B is incorrect as the unilateral throbbing headache with photophobia and nausea is suggestive of migraine headaches, which are usually not associated with serious underlying disorders. Choice C describes symptoms that are more indicative of tension-type headaches rather than a serious underlying disorder. Choice D presents symptoms that are more likely related to hormonal changes and migraines rather than a serious underlying disorder.

5. A 60-year-old male patient is receiving androgen therapy for the treatment of hypogonadism. Which of the following adverse effects should the nurse monitor for?

• A. Hepatotoxicity
• B. Nephrotoxicity
• C. Cardiotoxicity
• D. Pulmonary toxicity

Correct answer: A

Rationale: The correct answer is A: Hepatotoxicity. Androgen therapy, such as testosterone, can lead to hepatotoxicity, which is toxic to the liver. Therefore, the nurse should monitor the patient's liver function. Choices B, C, and D are incorrect because androgen therapy is not typically associated with nephrotoxicity, cardiotoxicity, or pulmonary toxicity.

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