Nursing Elites

1. In which patient would the manifestation of a headache be a sign of a serious underlying disorder?

• A. A 55-year-old man with new onset of headaches that are worse at night and reported mood swings according to his family
• B. A 30-year-old woman with a unilateral throbbing headache with photophobia and nausea
• C. A 60-year-old man with his head feeling full and throbbing and muscle aching around his neck and shoulders
• D. A 40-year-old woman who experiences food cravings, gets irritable, and then develops a pulsatile-like headache on the right side of her head

Correct answer: A

Rationale: The correct answer is A. New onset headaches in older adults, especially if worse at night, may indicate a serious condition like a brain tumor. Choice B describes symptoms commonly seen in migraines. Choice C describes tension-type headaches. Choice D describes symptoms of a menstrual migraine which is not typically associated with a serious underlying disorder.

2. Which of the following best describes Cushing’s syndrome?

• A. Hypersecretion of growth hormone
• B. Excessive production of cortisol by the adrenal glands
• C. Insufficient production of insulin
• D. Increased levels of ACTH

Correct answer: B

Rationale: Cushing’s syndrome is characterized by the excessive production of cortisol by the adrenal glands, not growth hormone (Choice A), insulin (Choice C), or ACTH (Choice D). The increased cortisol levels lead to a variety of symptoms associated with Cushing’s syndrome.

3. When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is:

• A. positively charged.
• B. inhibitory.
• C. overstimulated.
• D. dormant.

Correct answer: B

Rationale: Acetylcholine acts as an inhibitory neurotransmitter at the sinoatrial node. It slows down the heart rate by decreasing the firing rate of the sinoatrial node, which serves as the heart's natural pacemaker. Neurotransmitters do not have a charge, so choice A is incorrect. Choice C is wrong as overstimulation is not a characteristic of acetylcholine at the sinoatrial node. Choice D is also incorrect because acetylcholine actively influences heart rate regulation when released at the sinoatrial node.

4. A patient has acute respiratory failure (ARF). Which of the following would the nurse expect to find?

• A. Alkalosis and hyperventilation
• B. Hypoxemia and hypercapnia
• C. Alkalosis and high potassium
• D. Elevated sodium and acidosis

Correct answer: B

Rationale: In acute respiratory failure, hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide) are commonly observed. Choice A is incorrect because alkalosis (high pH) and hyperventilation are not typically seen in acute respiratory failure. Choice C is incorrect as it mentions alkalosis and high potassium, which are not characteristic of acute respiratory failure. Choice D is also incorrect because elevated sodium and acidosis are not typically associated with acute respiratory failure.

5. Which of the following correctly identifies the plasma protein inflammatory mediator systems?

• A. Phagocytic, interferon, and complement systems.
• B. Complement, fibrinolytic, and clotting systems.
• C. Complement, clotting, and kinin systems.
• D. Complement, clotting, and acute phase reactant systems.

Correct answer: C

Rationale: The correct answer is C: Complement, clotting, and kinin systems. These are the three main plasma protein inflammatory mediator systems. The complement system helps in inflammation and immune responses, the clotting system is involved in blood coagulation, and the kinin system regulates inflammation and blood pressure. Choice A is incorrect because interferon is not part of the plasma protein inflammatory mediator systems. Choice B is incorrect because the fibrinolytic system is not a primary inflammatory mediator system. Choice D is incorrect because acute phase reactants are not part of the plasma protein inflammatory mediator systems.

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