Nursing Elites

1. How are type IV hypersensitivity reactions different from all other types (I, II, or III) of hypersensitivity reactions?

• A. They involve antigen-antibody complexes.
• B. They are mediated by T cells and do not involve antibodies.
• C. They result in immediate allergic reactions.
• D. They are the least severe form of hypersensitivity.

Correct answer: B

Rationale: Type IV hypersensitivity reactions are mediated by T cells and cytokine release, leading to delayed reactions, unlike types I, II, and III, which involve antibodies. Choice A is incorrect because type IV reactions do not involve antigen-antibody complexes. Choice C is incorrect as type IV reactions do not result in immediate allergic reactions. Choice D is incorrect as type IV reactions are not the least severe form of hypersensitivity; in fact, they are known to cause significant tissue damage and inflammation.

2. A client with liver cirrhosis is at risk for developing hepatic encephalopathy. Which clinical manifestation should the nurse monitor for?

• A. Kussmaul respirations
• B. Asterixis (flapping tremor)
• C. Bradycardia
• D. Hypertension

Correct answer: B

Rationale: Corrected Rationale: Asterixis, also known as a flapping tremor, is a common sign of hepatic encephalopathy, indicating neurological dysfunction due to liver failure. Kussmaul respirations (option A) are associated with metabolic acidosis, which is not a typical manifestation of hepatic encephalopathy. Bradycardia (option C) and hypertension (option D) are not typically associated with hepatic encephalopathy; in fact, hepatic encephalopathy is more commonly associated with alterations in mental status, neuromuscular abnormalities, and changes in behavior.

3. A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy at 2 liters per minute via a nasal cannula. Which assessment finding indicates a potential complication of oxygen therapy?

• A. Increased respiratory rate
• B. Decreased level of consciousness
• C. Improved oxygen saturation
• D. Complaints of dry mouth

Correct answer: B

Rationale: In clients with COPD, oxygen therapy can lead to a decrease in the respiratory drive caused by the removal of the hypoxic drive. This can result in carbon dioxide retention, leading to a decreased level of consciousness. Options A, C, and D are incorrect because an increased respiratory rate is typically a sign of hypoxia, improved oxygen saturation is a positive response to oxygen therapy, and complaints of dry mouth are not directly related to oxygen therapy complications in this scenario.

4. A new mother asks the clinic nurse if she must continue giving her baby nystatin for thrush since the white lesions on his tongue have disappeared. What response by the nurse is most appropriate?

• A. No. When the lesions have disappeared, you may stop the nystatin.
• B. Yes. You should continue it for the full 7 days.
• C. No. Thrush is a self-limiting disorder, and nystatin is given for complete treatment.
• D. Yes. The medication should be refilled for a second week of therapy.

Correct answer: B

Rationale: The correct answer is B because nystatin should be given for the full 7 days even if the lesions are no longer present. Continuing the treatment for the prescribed duration ensures complete eradication of the fungal infection. Choice A is incorrect as stopping the medication prematurely may lead to the reoccurrence of thrush. Choice C is inaccurate as nystatin is not just for comfort but for effective treatment. Choice D is incorrect as refilling the medication for a second week without medical advice may lead to unnecessary prolonged use and potential side effects.

5. Which type of lipoprotein is associated with decreasing the risk of atherosclerosis?

• A. High-density lipoprotein (HDL)
• B. Low-density lipoprotein (LDL)
• C. Very low-density lipoprotein (VLDL)
• D. Intermediate-density lipoprotein (IDL)

Correct answer: A

Rationale: The correct answer is High-density lipoprotein (HDL). HDL is known as 'good' cholesterol because it helps remove cholesterol from the arteries, reducing the risk of atherosclerosis. LDL (choice B) is considered 'bad' cholesterol as it can deposit cholesterol in the arteries, increasing the risk of atherosclerosis. VLDL (choice C) and IDL (choice D) are also associated with increased risk of atherosclerosis rather than decreasing it.

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