Nursing Elites

1. 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.

2. During a flu shot clinic, one of the questions the student nurse asks relates to whether the client has a history of Guillain-Barré syndrome. The client asks, 'What is that?' How should the nursing student reply?

• A. A type of paralysis that affects movement on both sides of the body. It may even involve the respiratory muscles.
• B. Swelling of your arm where you got your flu shot and maybe your eyes and lips had some swelling as well.
• C. A degenerative disease where you have trouble walking without the help of a cane or walker.
• D. Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot.

Correct answer: A

Rationale: The correct answer is A because Guillain-Barré syndrome is an acute immune-mediated polyneuropathy that can lead to paralysis affecting movement on both sides of the body, and in severe cases, involving the respiratory muscles. Choice B is incorrect as it describes local swelling, not the systemic effects of Guillain-Barré syndrome. Choice C is incorrect as it describes a degenerative disease affecting mobility, not an acute immune-mediated condition like Guillain-Barré syndrome. Choice D is incorrect as it describes flu-like symptoms following a flu shot, which is not the same as Guillain-Barré syndrome.

3. A patient taking hormonal contraceptives will soon turn 35 years of age. She is moderately obese and has smoked for 15 years. Which of the following is most important?

• A. Begin an exercise regimen.
• B. Begin smoking cessation.
• C. Begin daily aspirin therapy.
• D. Begin taking a loop diuretic to aid weight loss.

Correct answer: B

Rationale: The most important action for a patient taking hormonal contraceptives, who is nearing 35 years of age, moderately obese, and has a history of smoking for 15 years, is to begin smoking cessation. Women over 35, especially smokers, are at an increased risk of blood clots and cardiovascular issues when using hormonal contraceptives. Smoking cessation is crucial to reduce this risk. Beginning an exercise regimen may be beneficial for overall health but is not as critical as stopping smoking in this scenario. Daily aspirin therapy or taking a loop diuretic are not indicated in this situation and may not address the primary risk associated with hormonal contraceptives and smoking.

4. A male patient with benign prostatic hyperplasia (BPH) is being treated with tamsulosin (Flomax). What should the nurse include in the teaching plan for this patient?

• A. Avoid lying down after taking the medication.
• B. Take the medication with meals.
• C. Report any side effects such as dizziness or fainting.
• D. Take the medication at bedtime.

Correct answer: C

Rationale: The correct answer is C: 'Report any side effects such as dizziness or fainting.' Patients taking tamsulosin should be advised to report any side effects, such as dizziness or fainting, which can occur due to orthostatic hypotension. Choices A, B, and D are incorrect because avoiding lying down after taking the medication, taking it with meals, or at bedtime are not specific teaching points related to the potential side effects of tamsulosin.

5. When evaluating the success of adding raltegravir to the drug regimen of a 42-year-old female patient with HIV, which laboratory value should the nurse prioritize?

• A. The patient's C-reactive protein levels
• B. The patient's erythrocyte sedimentation rate (ESR)
• C. The patient's viral load
• D. The patient's CD4 count

Correct answer: C

Rationale: The correct answer is C: The patient's viral load. In HIV management, monitoring the viral load is crucial to assess the effectiveness of antiretroviral therapy. A decrease in viral load indicates the treatment's success in controlling the HIV infection. Choices A, B, and D are less relevant in this context. C-reactive protein levels and erythrocyte sedimentation rate are markers of inflammation and non-specific indicators of infection, not specifically for HIV. CD4 count is important but not as immediate for evaluating the response to the newly added medication compared to monitoring the viral load.

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