Nursing Elites

1. What aspect of hormonal contraceptives places a woman at the greatest risk for the development of blood clots?

• A. Hormonal contraceptives increase serum triglyceride and cholesterol levels.
• B. Hormonal contraceptives increase platelet levels.
• C. Hormonal contraceptives increase blood levels of clotting factors.
• D. Hormonal contraceptives cause injury to blood vessel linings.

Correct answer: C

Rationale: The correct answer is C. Hormonal contraceptives increase blood levels of clotting factors, particularly factors II, VII, IX, and X. This elevation in clotting factors can predispose individuals to thromboembolic events, including blood clots. Choices A, B, and D are incorrect because hormonal contraceptives do not have a significant effect on serum triglycerides and cholesterol, platelet levels, or causing direct injury to blood vessel linings as the primary mechanism for clot formation.

2. 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.

3. The healthcare provider is caring for a client with an altered level of consciousness and needs to assess the withdrawal reflex. Which action should the healthcare provider perform?

• A. Apply a painful stimulus to see if the client pulls away.
• B. Check for pupil response to light.
• C. Assess the client's response to verbal commands.
• D. Observe the client's reaction to a cold stimulus.

Correct answer: A

Rationale: The withdrawal reflex is assessed by applying a painful stimulus and observing if the client pulls away. This response indicates a functioning reflex arc. Choices B, C, and D are incorrect as they do not involve testing the withdrawal reflex specifically. Checking for pupil response to light assesses the pupillary reflex, assessing the client's response to verbal commands evaluates their cognitive function, and observing the client's reaction to a cold stimulus tests for a different type of sensory response.

4. Which of the following wounds is most likely to heal by secondary intention?

• A. A finger laceration received while cutting onions
• B. A stage IV pressure ulcer that developed in a nursing home
• C. A needlestick injury received while administering parenteral medication
• D. An incision from an open appendectomy

Correct answer: B

Rationale: A stage IV pressure ulcer is a deep wound involving tissue loss that typically heals by secondary intention. This process involves the wound healing from the bottom up with granulation tissue and often results in significant scarring. Choice A, a finger laceration, would generally heal by primary intention due to its clean edges and minimal tissue loss. Choice C, a needlestick injury, is likely to be sutured and heal by primary intention since it is a small, clean wound. Choice D, an incision from an open appendectomy, is usually closed with sutures and heals by primary intention as well.

5. A nurse is conducting an assessment on a client who presents with symptoms that are characteristic of amyotrophic lateral sclerosis (ALS). What assessment finding would be expected in this client?

• A. Reduced reflexes in all four limbs
• B. Decreased cognitive function
• C. Involuntary muscle contractions
• D. Hyperreflexia

Correct answer: D

Rationale: The correct answer is D: Hyperreflexia. In amyotrophic lateral sclerosis (ALS), hyperreflexia is a common assessment finding due to the degeneration of upper motor neurons. This results in an overactive reflex response to stimuli. Reduced reflexes in all four limbs (choice A) are not typically seen in ALS; instead, hyperreflexia is more common. Decreased cognitive function (choice B) is not a primary characteristic of ALS. Involuntary muscle contractions (choice C) are more indicative of conditions such as dystonia or myoclonus, not ALS.

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