Nursing Elites

1. A report comes back indicating that muscular atrophy has occurred. A nurse recalls that muscular atrophy involves a decrease in muscle cell size:

• A. Number
• B. Size
• C. Vacuoles
• D. Lipofuscin

Correct answer: B

Rationale: The correct answer is B: Size. Muscular atrophy is characterized by a reduction in the size of muscle cells. This decrease in size can be due to various factors such as disuse, aging, or disease. Choice A, Number, is incorrect because muscular atrophy does not involve a decrease in the number of muscle cells but rather their size. Choice C, Vacuoles, is incorrect as vacuoles are not directly related to the definition of muscular atrophy. Choice D, Lipofuscin, is incorrect as lipofuscin is a pigment associated with aging and has no direct connection to the decrease in muscle cell size seen in muscular atrophy.

2. How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

• A. Administer radioactive cobalamin and measure its excretion time
• B. Measure antigen-antibody immune complexes
• C. Measure serum ferritin and total iron-binding capacity
• D. Administer folate and evaluate folate content in a blood serum sample

Correct answer: A

Rationale: The correct answer is A. To prepare a patient for a Schilling test for pernicious anemia, the nurse should administer radioactive cobalamin and measure its excretion time. This test is specifically designed to assess the absorption of vitamin B12. Choices B, C, and D are incorrect because they do not align with the preparation and procedure of a Schilling test. Measuring antigen-antibody immune complexes, serum ferritin, or total iron-binding capacity, as well as administering folate and evaluating folate content, are not part of the Schilling test protocol.

3. A healthcare provider is explaining to a patient the difference between primary and secondary immunodeficiency disorders and explains that secondary immunodeficiencies (select ONE that does not apply):

• A. May develop after viral infections
• B. Develop before birth
• C. May develop following immunosuppressive therapies
• D. Are caused by superimposed conditions

Correct answer: B

Rationale: The correct statements about secondary immunodeficiencies are that they may develop after viral infections, following immunosuppressive therapies, and are caused by superimposed conditions. Choice B ('Develop before birth') is incorrect because secondary immunodeficiencies do not develop before birth. They are acquired later in life. Therefore, the correct answers are A, C, and D.

4. Women who have breast cancer due to a BRCA1 gene mutation are usually:

• A. positive for human epidermal growth factor receptor 1 and 2.
• B. negative for estrogen receptor.
• C. positive for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2.
• D. negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2.

Correct answer: D

Rationale: Women with breast cancer due to a BRCA1 gene mutation commonly have a triple-negative breast cancer subtype, which means they are negative for estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2). This subtype tends to be more aggressive and harder to treat. Choice A is incorrect as they are typically negative for HER2. Choice B is incorrect because they are usually negative for estrogen receptor. Choice C is incorrect as they are usually negative for progesterone receptor and HER2.

5. In addition to matching ABO antigens, a blood transfusion must also be matched for:

• A. HLA type
• B. Rh antigen
• C. Immunoglobulins
• D. Platelet compatibility

Correct answer: B

Rationale: The correct answer is B: Rh antigen. In addition to ABO antigens, Rh antigen must also be matched for a blood transfusion. Rh antigen compatibility is crucial to prevent adverse reactions. Choice A, HLA type, is not directly related to blood transfusions but plays a role in organ transplantation. Choice C, Immunoglobulins, are not typically matched for blood transfusions. Choice D, Platelet compatibility, while important in specific cases, is not a standard requirement for all blood transfusions.

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