Nursing Elites

1. As you are walking in the park, a huge black Labrador runs up to you and places his paws on your shoulders. Immediately your heart starts racing, you feel palpitations, anxiety, and your hands become a little shaky. The nurse knows that this response is primarily caused by:

• A. cerebral cortex.
• B. somatic nervous system.
• C. limbic system.
• D. autonomic nervous system.

Correct answer: D

Rationale: The autonomic nervous system controls involuntary bodily functions like heart rate, respiration, and sweating. In the given scenario, the 'fight or flight' response is activated, leading to increased heart rate, palpitations, anxiety, and shaky hands. The cerebral cortex is involved in conscious thought processes and decision-making, not the immediate physiological response observed here. The somatic nervous system regulates voluntary movements, while the limbic system is responsible for emotions and memory, but the autonomic nervous system is primarily responsible for the physiological responses seen in this situation.

2. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?

• A. Eosinophils
• B. Neutrophils
• C. Leukotrienes
• D. Monocytes

Correct answer: B

Rationale: Neutrophils are the first responders to a bacterial infection. They are phagocytes that engulf and destroy bacteria, playing a crucial role in the early stages of the immune response. Eosinophils are primarily involved in combating parasitic infections and allergic reactions, not bacterial infections. Leukotrienes are signaling molecules that contribute to inflammation and immune responses, but they are not cells. Monocytes are another type of white blood cell that differentiates into macrophages and dendritic cells, playing a role in immune response but not as immediate as neutrophils.

3. Which of the following chronic inflammatory skin diseases is characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation?

• A. Psoriasis
• B. Melanoma
• C. Atopic dermatitis
• D. Urticaria

Correct answer: A

Rationale: Psoriasis is the correct answer because it is a chronic inflammatory skin condition characterized by features such as angiogenesis (formation of new blood vessels), immune cell activation (especially T cells), and excessive keratinocyte proliferation. This results in the typical symptoms seen in psoriasis, such as red, scaly patches on the skin. Melanoma is a type of skin cancer arising from melanocytes, not characterized by the features mentioned. Atopic dermatitis is a different skin condition involving eczematous changes, not specifically associated with the described characteristics of psoriasis. Urticaria is a skin condition characterized by hives and does not involve the same pathophysiological processes as psoriasis.

4. A nurse is educating a client with peripheral artery disease (PAD). Which statement made by the client indicates a need for further teaching?

• A. I should avoid walking for long periods to prevent leg pain.
• B. I should inspect my feet daily for any sores or wounds.
• C. I should wear compression stockings to improve circulation.
• D. I should avoid smoking to prevent further damage to my arteries.

Correct answer: A

Rationale: The correct answer is A. Walking is crucial in improving circulation in peripheral artery disease; therefore, the client should not avoid walking for long periods. Choices B, C, and D are correct statements for a client with PAD. Inspecting feet daily helps in early detection of sores or wounds, wearing compression stockings improves circulation, and avoiding smoking helps prevent further damage to arteries in PAD.

5. What clinical manifestations would the nurse expect to find in a client who is experiencing anaphylaxis?

• A. Dilated bronchioles, constriction of peripheral blood vessels, decreased capillary permeability
• B. Asthma, deep vein thrombosis, hepatic encephalopathy
• C. Narrowing of the bronchioles, dilation of the peripheral blood vessels, increased capillary permeability
• D. Left-sided heart failure, pulmonary embolism, urinary tract infection

Correct answer: C

Rationale: In anaphylaxis, the client would present with narrowing of the bronchioles, dilation of the peripheral blood vessels, and increased capillary permeability. These manifestations lead to symptoms such as difficulty breathing, low blood pressure, and swelling. Choices A, B, and D are incorrect because they do not describe the typical clinical manifestations of anaphylaxis.

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