Nursing Elites

1. What are direct effects of antibodies? (Select ONE that does not apply):

• A. Neutralization
• B. Agglutination
• C. Precipitation
• D. Phagocytosis

Correct answer: D

Rationale: The direct effects of antibodies include neutralization, agglutination, and precipitation. Antibodies neutralize pathogens by binding to them and preventing their harmful effects. Agglutination involves the clumping together of pathogens, making it easier for phagocytes to engulf them. Precipitation refers to the process where antibodies bind to soluble antigens, forming large complexes that are easily removed from the body. Phagocytosis, on the other hand, is an indirect effect of antibodies where phagocytes engulf and destroy pathogens opsonized by antibodies, not a direct effect.

2. Prior to leaving on a backpacking trip to Southeast Asia, a college student has received a tetanus booster shot. This immunization confers protection by way of what immune process?

• A. Passive natural immunity
• B. Active natural immunity
• C. Passive artificial immunity
• D. Active artificial immunity

Correct answer: D

Rationale: The correct answer is D: Active artificial immunity. A tetanus booster shot confers protection through active artificial immunity. Active immunity involves the body producing its antibodies in response to an antigen, providing long-lasting protection. In this case, the tetanus booster shot triggers the student's immune system to produce specific antibodies against tetanus toxins. Choices A, B, and C are incorrect because passive immunity does not involve the individual's immune system producing antibodies; instead, it involves the direct transfer of antibodies from another source (natural or artificial) for immediate, but temporary, protection.

3. A client with a history of smoking presents with a chronic cough and shortness of breath. The nurse should suspect which condition?

• A. Pulmonary fibrosis
• B. Chronic obstructive pulmonary disease (COPD)
• C. Lung cancer
• D. Pulmonary edema

Correct answer: B

Rationale: The correct answer is B: Chronic obstructive pulmonary disease (COPD). COPD is often associated with a chronic cough and shortness of breath, especially in individuals with a history of smoking. Pulmonary fibrosis (choice A) typically presents with progressive dyspnea and dry cough. Lung cancer (choice C) may present with a chronic cough, shortness of breath, and other symptoms like weight loss and hemoptysis. Pulmonary edema (choice D) presents with symptoms such as acute shortness of breath, orthopnea, and pink, frothy sputum.

4. A patient has been diagnosed with a fungal infection and is to be treated with itraconazole (Sporanox). Prior to administration, the nurse notes that the patient is taking carbamazepine (Tegretol) for a seizure disorder. Based on this medication regime, which of the following will be true regarding the medications?

• A. The serum level of carbamazepine will be increased.
• B. The patient's carbamazepine should be discontinued.
• C. The patient's antiseizure medication should be changed.
• D. The patient will require a higher dosage of itraconazole (Sporanox).

Correct answer: A

Rationale: When itraconazole is administered with carbamazepine, itraconazole may increase the serum levels of carbamazepine, potentially leading to toxicity. Therefore, choice A is correct. Discontinuing carbamazepine (choice B) or changing the antiseizure medication (choice C) is not necessary unless advised by a healthcare provider. Choice D, requiring a higher dosage of itraconazole, is not accurate in this scenario.

5. A toddler is displaying signs/symptoms of weakness and muscle atrophy. The pediatric neurologist suspects it may be a lower motor neuron disease called spinal muscular atrophy (SMA). The client's family asks how he got this. The nurse will respond:

• A. This could result from playing in soil and then ingesting bacteria that is now attacking his motor neurons.
• B. No one really knows how this disease is formed. We just know that in time, he may grow out of it.
• C. This is a degenerative disorder that tends to be inherited as an autosomal recessive trait.
• D. This is a segmental demyelination disorder that affects all nerve roots and eventually all muscle groups as well.

Correct answer: C

Rationale: The correct answer is C. Spinal muscular atrophy (SMA) is an inherited disorder, often autosomal recessive, that affects lower motor neurons. Choice A is incorrect because SMA is not caused by ingesting bacteria from playing in soil. Choice B is incorrect as SMA is not something that a person grows out of. Choice D is incorrect because SMA is not a demyelination disorder that affects nerve roots and muscle groups.

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