Nursing Elites

1. A patient underwent an open cholecystectomy 4 days ago, and her incision is now in the proliferative phase of healing. The nurse knows that the next step in the process of wound healing is:

• A. Inflammation
• B. Maturation
• C. Remodeling
• D. Coagulation

Correct answer: C

Rationale: In the context of wound healing, after the proliferative phase comes the remodeling phase. During the remodeling phase, the wound gains strength as collagen fibers reorganize, and the scar matures. Inflammation is the initial phase of healing, where the body responds to injury with redness, swelling, and warmth. Maturation is the final stage where the scar tissue continues to undergo changes but is not the immediate next step after the proliferative phase. Coagulation is the process of blood clot formation and is not a phase in wound healing.

2. Which of the following is an example of a Type 1 hypersensitivity reaction?

• A. Anaphylaxis
• B. Indigestion
• C. Beta cell destruction
• D. ABO transfusion reaction

Correct answer: A

Rationale: Anaphylaxis is a classic example of a Type 1 hypersensitivity reaction. In Type 1 hypersensitivity, allergens trigger an immediate immune response mediated by IgE antibodies, leading to the release of histamine and other mediators. This reaction can result in symptoms ranging from mild itching and hives to severe conditions like anaphylaxis, which is a life-threatening emergency. The other options, such as indigestion (choice B), beta cell destruction (choice C), and ABO transfusion reaction (choice D), are not classified as Type 1 hypersensitivity reactions. Indigestion is typically related to gastrointestinal disturbances, beta cell destruction is associated with autoimmune conditions like type 1 diabetes, and ABO transfusion reaction involves antibodies targeting incompatible blood groups, which is a different immune mechanism compared to Type 1 hypersensitivity.

3. A patient is receiving oral nystatin suspension for a fungal infection of the mouth. Which of the following adverse effects is most likely to be experienced with this form of nystatin?

• A. Local irritation
• B. Burning
• C. Nausea
• D. Urinary urgency

Correct answer: A

Rationale: The correct answer is A: Local irritation. When using oral nystatin suspension for a fungal infection of the mouth, local irritation is the most likely adverse effect that a patient may experience. Nystatin is generally well-tolerated, but some patients may develop local irritation, such as mouth or throat irritation. Choices B, C, and D are less likely adverse effects of oral nystatin suspension. Burning, nausea, and urinary urgency are not commonly associated with nystatin use for a fungal infection of the mouth.

4. After a patient is exposed to a specific antigen, B cells will differentiate into:

• A. B cytotoxic cells
• B. Plasma cells
• C. Bursal cells
• D. Clonal equivalents

Correct answer: B

Rationale: After exposure to a specific antigen, B cells undergo differentiation into plasma cells. Plasma cells are responsible for producing antibodies in response to the antigen. Choice A ('B cytotoxic cells') is incorrect because B cells do not differentiate into cytotoxic cells; cytotoxic cells are typically associated with T cells. Choice C ('Bursal cells') is incorrect as bursal cells are specific to birds and not relevant to human immune responses. Choice D ('Clonal equivalents') is incorrect as it does not describe the differentiation process of B cells exposed to antigens.

5. A male patient receiving androgen therapy is concerned about the risk of prostate cancer. What should the nurse explain regarding this risk?

• A. Finasteride has been shown to lower the risk of developing prostate cancer.
• B. Finasteride does not affect the risk of prostate cancer.
• C. Finasteride may increase the risk of developing prostate cancer, so regular screenings are recommended.
• D. Finasteride has no effect on the risk of prostate cancer, so regular screenings are unnecessary.

Correct answer: A

Rationale: The correct answer is A. Finasteride has been shown to lower the risk of developing prostate cancer. However, regular screenings are still recommended to monitor for any potential issues. Choice B is incorrect because finasteride has been associated with a reduced risk of developing prostate cancer. Choice C is incorrect as finasteride is not known to increase the risk of prostate cancer; in fact, it has shown a protective effect. Choice D is incorrect because while finasteride may lower the risk of prostate cancer, regular screenings are still necessary to ensure early detection and treatment if needed.

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