Nursing Elites

1. After a patient is exposed to a specific antigen, B cells will differentiate into:

• A. B cytotoxic cells
• B. Plasma cells
• C. Bursal cells
• D. Clonal equivalents

Correct answer: B

Rationale: After exposure to a specific antigen, B cells undergo differentiation into plasma cells. Plasma cells are responsible for producing antibodies in response to the antigen. Choice A ('B cytotoxic cells') is incorrect because B cells do not differentiate into cytotoxic cells; cytotoxic cells are typically associated with T cells. Choice C ('Bursal cells') is incorrect as bursal cells are specific to birds and not relevant to human immune responses. Choice D ('Clonal equivalents') is incorrect as it does not describe the differentiation process of B cells exposed to antigens.

2. 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.

3. Staff at the care facility note that a woman has started complaining of back pain in recent weeks and occasionally groans in pain. She has many comorbidities that require several prescription medications. The nurse knows that which factor is likely to complicate the clinician's assessment and treatment of the client's pain?

• A. Her advanced age may influence the expression and perception of pain.
• B. Her polypharmacy may complicate the pain management process.
• C. Her underlying conditions may mask or exacerbate the pain.
• D. Her cognitive function may decline, making pain assessment difficult.

Correct answer: B

Rationale: Polypharmacy, or the use of multiple medications, can complicate pain management due to drug interactions and side effects. While advanced age can influence pain perception, it is not the most likely factor to complicate assessment and treatment in this scenario. Underlying conditions may affect pain perception but do not directly complicate the management process. Cognitive decline can hinder pain assessment, but in this case, the focus is on factors directly impacting the treatment process, making option B the most appropriate choice.

4. Macular degeneration occurs as a result of:

• A. loss of lens accommodation
• B. detachment of the retina
• C. increased intraocular pressure
• D. impaired blood supply leading to cellular waste accumulation and ischemia

Correct answer: D

Rationale: Macular degeneration is a condition that affects the macula, a part of the retina responsible for central vision. It is primarily caused by impaired blood supply to the macula, leading to cellular waste accumulation and ischemia. This results in the death of photoreceptor cells and ultimately vision loss. Choices A, B, and C are incorrect because macular degeneration is not related to the loss of lens accommodation, detachment of the retina, or increased intraocular pressure. The correct answer directly addresses the underlying pathophysiology of macular degeneration.

5. A client with atrial fibrillation is at risk for which of the following complications?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Hypertensive crisis
• D. Myocardial infarction

Correct answer: B

Rationale: Corrected Rationale: A client with atrial fibrillation is at increased risk of thromboembolism due to blood stasis in the atria. This can lead to the formation of blood clots, which may travel to the lungs and cause a pulmonary embolism. Pulmonary embolism is a serious complication of atrial fibrillation. Choices A, C, and D are incorrect because while atrial fibrillation can lead to complications such as stroke or heart failure, it is specifically associated with an increased risk of pulmonary embolism due to the clot formation associated with the condition.

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