Nursing Elites

1. In chronic obstructive pulmonary disease, the inflammatory response predominantly involves:

• A. eosinophils
• B. neutrophils
• C. monocytes
• D. cells

Correct answer: B

Rationale: In chronic obstructive pulmonary disease, the inflammatory response predominantly involves neutrophils. Neutrophils play a key role in COPD due to their involvement in initiating and sustaining the inflammatory process. Eosinophils are more commonly associated with asthma rather than COPD. Monocytes are less involved in the inflammatory response in COPD compared to neutrophils. The choice 'cells' is too broad and vague to be a specific answer in this context.

2. When assessing a 7-year-old child's pain after an emergency appendectomy, what is the most appropriate tool for the nurse to use?

• A. Use a visual analog scale (VAS) to assess the pain.
• B. Ask the child to rate their pain on a scale of 0 to 10.
• C. Use the Wong-Baker FACES scale to assess the pain.
• D. Ask the parents to describe the child's pain behavior.

Correct answer: C

Rationale: The correct answer is to use the Wong-Baker FACES scale to assess the child's pain. This scale is specifically designed for children and uses facial expressions of varying intensities to help them communicate their pain levels effectively. Choices A and B may not be as suitable for a young child who may have difficulty understanding or using a numerical scale. Choice D involving parents may not provide an accurate reflection of the child's pain experience, as it is essential to assess the child's self-reporting.

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 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.

5. 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.

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