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. When caring for a patient with systemic lupus erythematosus (SLE), the disease the nurse is dealing with is an example of:

• A. Autoimmunity
• B. Alloimmunity
• C. Homoimmunity
• D. Alleimmunity

Correct answer: A

Rationale: When a nurse cares for a patient with systemic lupus erythematosus (SLE), the nurse is dealing with an autoimmune disease. In autoimmune diseases like SLE, the immune system mistakenly attacks the body's own tissues. Choice A, 'Autoimmunity,' is the correct answer because SLE is an example of the immune system attacking self-antigens, leading to tissue damage and inflammation. Choices B, C, and D are incorrect. Alloimmunity refers to the immune response against foreign antigens from members of the same species, homoimmunity is not a recognized term in immunology, and alleimmunity is not a valid term in this context.

3. A patient has been prescribed mifepristone (RU-486) to terminate a pregnancy. How does this drug achieve its therapeutic effect?

• A. By inhibiting the action of progesterone, which is necessary to maintain pregnancy.
• B. By increasing estrogen levels, which induce uterine contractions.
• C. By altering the uterine lining, preventing implantation.
• D. By stimulating uterine contractions, which expel the embryo.

Correct answer: A

Rationale: Mifepristone (RU-486) functions by inhibiting the action of progesterone, a hormone crucial for maintaining pregnancy. By blocking progesterone, mifepristone disrupts the uterine environment necessary for pregnancy continuation, ultimately leading to termination. Choice B is incorrect because mifepristone does not increase estrogen levels; instead, it acts on progesterone. Choice C is incorrect as mifepristone's mechanism does not involve altering the uterine lining to prevent implantation. Choice D is incorrect because mifepristone does not directly stimulate uterine contractions; its primary action is through progesterone inhibition.

4. A patient taking oral contraceptives reports breakthrough bleeding. What should the nurse assess in this patient?

• A. Adherence to the medication schedule
• B. The possibility of pregnancy
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: A

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding can be a sign of missed doses or inconsistent timing, which can decrease the effectiveness of oral contraceptives. Assessing the patient's adherence helps in ensuring proper use of the medication. Choices B, C, and D are incorrect because breakthrough bleeding is more likely related to adherence issues rather than pregnancy, the need for increased dosage, or the effectiveness of the current oral contraceptive.

5. A patient with a history of breast cancer is prescribed tamoxifen (Nolvadex). What critical information should the nurse include in the patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
• B. Tamoxifen may cause weight gain, so patients should monitor their diet.
• C. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.
• D. Tamoxifen may cause hot flashes and other menopausal symptoms.

Correct answer: A

Rationale: Tamoxifen increases the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots and the importance of seeking immediate medical attention if they occur.

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