Nursing Elites

1. A woman is being treated with clomiphene citrate for the treatment of infertility. She states to the nurse that she has seen an increase in vaginal discharge. The nurse knows that this effect is related to:

• A. Increased blood flow to the vaginal area.
• B. Increased cervical mucus production.
• C. Increased production of vaginal secretions.
• D. Increased lubrication in the vaginal canal.

Correct answer: C

Rationale: The correct answer is C: 'Increased production of vaginal secretions.' Clomiphene citrate affects cervical mucus production, leading to an increase in vaginal secretions. This effect is beneficial for fertility as it helps create a more hospitable environment for sperm transport. Choice A, 'Increased blood flow to the vaginal area,' is incorrect as the increase in vaginal discharge is primarily due to changes in cervical mucus. Choice B, 'Increased cervical mucus production,' is partially correct but does not fully explain the increase in vaginal secretions. Choice D, 'Increased lubrication in the vaginal canal,' is not directly related to the effect seen with clomiphene citrate treatment for infertility.

2. Anemia of chronic inflammation is generally classified as:

• A. hypochromic and microcytic.
• B. hypochromic and macrocytic.
• C. normochromic and microcytic.
• D. normochromic and normocytic.

Correct answer: D

Rationale: Anemia of chronic inflammation is characterized by normochromic and normocytic red blood cells. In chronic inflammation, the body typically produces enough red blood cells, but they are often smaller and paler than normal (normocytic and normochromic). Choices A, B, and C are incorrect because hypochromic and microcytic, hypochromic and macrocytic, and normochromic and microcytic anemias are not typically associated with chronic inflammation.

3. An experiment is designed to determine specific cell types involved in cell-mediated immune response. The experimenter is interested in finding cells that attack cells that have specific antigens. Which cells should be isolated?

• A. Lymphokine-producing cells
• B. Cytotoxic T cells
• C. Helper T cells
• D. Macrophages

Correct answer: B

Rationale: Cytotoxic T cells are the key players in cell-mediated immunity as they directly attack cells displaying specific antigens. Lymphokine-producing cells (Choice A) are involved in cytokine production, while Helper T cells (Choice C) assist in activating other immune cells. Macrophages (Choice D) are phagocytic cells that engulf and digest pathogens, but they are not the primary cells responsible for directly attacking cells with specific antigens in cell-mediated immunity.

4. A nurse practitioner is assessing a 7-year-old boy who has been brought to the clinic by his mother, who is concerned about her son's increasingly frequent, severe headaches. Which of the nurse's questions is least likely to yield data that will confirm or rule out migraines as the cause of his problem?

• A. Does your son experience nausea or vomiting when he has a headache?
• B. Does your son have a history of recent head injury?
• C. Does your son become sensitive to light when he has a headache?
• D. Does anyone in your family have a history of migraines?

Correct answer: B

Rationale: Asking about a history of recent head injury is less likely to yield data relevant to confirming or ruling out migraines. Migraines are often associated with symptoms like nausea, vomiting, sensitivity to light, and a family history of migraines. While head injuries can cause headaches, the focus of the assessment in this case should be on symptoms more specific to migraines to guide the diagnosis and management.

5. Although stress exposure initiates integrated responses by multiple systems, which system first activates the most important changes?

• A. Pulmonary
• B. Gastrointestinal
• C. Neuroendocrine
• D. Cardiovascular

Correct answer: C

Rationale: The correct answer is C, the Neuroendocrine system. When the body is exposed to stress, the neuroendocrine system plays a crucial role in initiating the body's response. This system, particularly through the hypothalamic-pituitary-adrenal axis, triggers a cascade of physiological responses to stress. Choices A, B, and D are incorrect because while other systems like the cardiovascular and gastrointestinal systems also respond to stress, the neuroendocrine system is primarily responsible for the initial and significant changes in the body's stress response.

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