Nursing Elites

1. What signs and symptoms most likely prompted this patient to initially seek care?

• A. Malaise and fatigue
• B. Severe diarrhea
• C. Intermittent fever
• D. Dizziness and confusion

Correct answer: B

Rationale: The correct answer is B: Severe diarrhea. A patient who has recently returned from a trip to Nepal with a nongovernmental organization and is seeking care for amebiasis would most likely have been prompted by the symptom of severe diarrhea. Amebiasis is an infection caused by the parasite Entamoeba histolytica, commonly transmitted through contaminated food or water sources in developing countries like Nepal. The hallmark symptom of amebiasis is dysentery, which is characterized by severe diarrhea with blood or mucus in the stool. Malaise and fatigue (choice A) are nonspecific symptoms that may accompany many illnesses and are not specific to amebiasis. Intermittent fever (choice C) is not a typical presenting symptom of amebiasis, which primarily manifests with gastrointestinal symptoms. Dizziness and confusion (choice D) are also not typical symptoms associated with amebiasis.

2. Cushing syndrome is characterized by which disorder?

• A. Hypocortisolism
• B. Exophthalmos
• C. Hypercortisolism
• D. Hyperpigmentation

Correct answer: C

Rationale: Cushing syndrome is characterized by hypercortisolism, which is an excessive amount of cortisol in the body. Choice A, 'Hypocortisolism,' is incorrect as Cushing syndrome is associated with elevated cortisol levels. Choice B, 'Exophthalmos,' refers to bulging eyes and is not a characteristic feature of Cushing syndrome. Hyperpigmentation, as mentioned in choice D, can be present in Cushing syndrome due to increased ACTH levels stimulating melanocytes, but it is not the defining characteristic of the syndrome.

3. A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, and respiratory difficulties. He is suffering from:

• A. Immunodeficiency
• B. Autoimmunity
• C. Anaphylaxis
• D. Tissue-specific hypersensitivity

Correct answer: C

Rationale: The correct answer is C: Anaphylaxis. Anaphylaxis is a severe, immediate allergic reaction mediated by IgE. In this scenario, the symptoms of itching, pain, swelling, redness, and respiratory difficulties following a bee sting are indicative of anaphylaxis. Choice A, Immunodeficiency, refers to a weakened immune system's inability to protect the body from infections and diseases, which is not the case here. Choice B, Autoimmunity, involves the immune system attacking healthy cells and tissues by mistake, which is not the mechanism at play in anaphylaxis. Choice D, Tissue-specific hypersensitivity, does not accurately describe the immediate, systemic reaction seen in anaphylaxis.

4. What does a client's symptoms of headache, vomiting, blurred vision, and loss of consciousness following a concussion indicate?

• A. Increased intracranial pressure
• B. Lower extremity compartment syndrome
• C. Consuming too much food at once
• D. Improved kidney function

Correct answer: A

Rationale: The symptoms of headache, vomiting, blurred vision, and loss of consciousness following a concussion are indicative of increased intracranial pressure. These symptoms suggest a serious condition that can occur after head trauma, requiring immediate medical attention. Lower extremity compartment syndrome presents with symptoms related to pressure build-up in the muscles of the legs, not the head. Consuming too much food at once does not manifest with these neurological symptoms. Improved kidney function would not present with symptoms such as headache, vomiting, blurred vision, and loss of consciousness.

5. What is the primary function of the kidneys in acid-base balance?

• A. The kidneys remove hydrogen ions and retain bicarbonate ions.
• B. The kidneys convert ammonia into urea, which is excreted in the urine.
• C. The kidneys produce aldosterone to regulate sodium levels.
• D. The kidneys secrete renin to regulate blood pressure.

Correct answer: A

Rationale: The correct answer is A. The kidneys are crucial in maintaining acid-base balance by removing hydrogen ions to decrease acidity and retaining bicarbonate ions to increase alkalinity. Choice B is incorrect because the conversion of ammonia into urea is related to nitrogen waste excretion, not acid-base balance. Choice C is incorrect as aldosterone regulates sodium levels, not acid-base balance. Choice D is also incorrect as renin is involved in regulating blood pressure, not acid-base balance.

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