Nursing Elites

1. A healthcare professional is documenting the recent vital signs for several clients on an acute medical ward of a hospital. Which hospital client with a noninfectious diagnosis would be most likely to have a fever?

• A. A 71-year-old female with limited mobility, chronic obstructive pulmonary disease (COPD), and vascular dementia
• B. A 33-year-old female with a postoperative deep vein thrombosis and pulmonary embolism
• C. A 51-year-old obese male with hepatic encephalopathy secondary to alcohol abuse
• D. A 71-year-old male with congestive heart failure and peripheral edema

Correct answer: B

Rationale: The correct answer is B. Pulmonary emboli can produce fever even without infection. This is known as a noninfectious cause of fever. Choices A, C, and D do not typically present with fever as a prominent symptom. Limited mobility, COPD, vascular dementia, hepatic encephalopathy, alcohol abuse, congestive heart failure, and peripheral edema are not directly associated with causing fever in the absence of infection, unlike pulmonary embolism.

2. A nurse is teaching a class about immune deficiencies, and a person from the audience asks which cells are affected by severe combined immune deficiency (SCID) syndrome, and the nurse answers:

• A. B cell deficits
• B. T cell deficits
• C. Complement deficits
• D. B and T cell deficits

Correct answer: D

Rationale: The correct answer is D: B and T cell deficits. Severe combined immune deficiency (SCID) syndrome affects both B and T cells, leading to a severe impairment in the immune system's ability to fight infections. Choice A (B cell deficits) is incorrect because SCID affects not only B cells but also T cells. Choice B (T cell deficits) is incorrect as SCID is characterized by deficits in both B and T cells. Choice C (Complement deficits) is incorrect as SCID primarily involves B and T cell deficiencies rather than complement deficiencies.

3. After studying about viruses, which information indicates the student has a good understanding of viruses? Viruses:

• A. Contain no RNA or DNA
• B. Are capable of independent reproduction
• C. Replicate their genetic material inside host cells
• D. Are killed easily by antimicrobials

Correct answer: C

Rationale: The correct answer is C. Viruses replicate their genetic material inside host cells, which is a fundamental aspect of their life cycle. Choice A is incorrect because viruses contain either RNA or DNA. Choice B is incorrect as viruses cannot reproduce independently and rely on host cells for replication. Choice D is incorrect as viruses are not easily killed by antimicrobials due to their unique structure and mechanisms of infection.

4. A toddler is displaying signs/symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The client's family asks how he got this. The nurse will respond:

• A. This could result from playing in soil and then ingesting bacteria that is now attacking his motor neurons.
• B. No one really knows how this disease is formed. We just know that in time, he may grow out of it.
• C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.
• D. This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well.

Correct answer: C

Rationale: The correct answer is C. Spinal muscular atrophy (SMA) is an inherited disorder, often autosomal recessive, that affects lower motor neurons. Choice A is incorrect because SMA is not caused by ingesting bacteria from playing in soil. Choice B is incorrect as SMA is not something that a person grows out of. Choice D is incorrect because SMA is not a demyelination disorder that affects nerve roots and muscle groups.

5. During a well-child checkup, a mother tells Nurse Rio about a recent situation in which her child needed to be disciplined by her husband. The child was slapped in the face for not getting her husband breakfast on Saturday, despite being told on Thursday never to prepare food for him. Nurse Rio analyzes the family system and concludes it is dysfunctional. All of the following factors contribute to this dysfunction except:

• A. Conflictual relationships between parents.
• B. Inconsistent communication patterns.
• C. Rigid, authoritarian roles.
• D. Use of violence to establish control.

Correct answer: C

Rationale: In a dysfunctional family system, conflictual relationships, inconsistent communication patterns, and the use of violence to establish control are factors contributing to dysfunction. However, rigid, authoritarian roles, though also dysfunctional, are not directly linked to the use of violence for control.

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