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. A patient with a history of venous thromboembolism is being considered for hormone replacement therapy (HRT). What should the nurse discuss with the patient regarding the risks of HRT?

• A. Discuss the potential for increased bone density.
• B. Discuss the potential for an increased risk of cardiovascular events.
• C. Discuss the potential for a reduced risk of breast cancer.
• D. Discuss the potential for improved mood and energy levels.

Correct answer: B

Rationale: The correct answer is B because hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including venous thromboembolism. Patients with a history of venous thromboembolism are at higher risk, so discussing this potential risk is crucial. Choice A, increased bone density, is not a major risk of HRT. Choice C, reduced risk of breast cancer, is not a common discussion point regarding HRT risks. Choice D, improved mood and energy levels, is more related to the benefits of HRT rather than its risks.

3. Which of the following is a sign of hypoglycemia?

• A. Rapid, deep breathing
• B. Increased urination
• C. Weakness and confusion
• D. High blood pressure

Correct answer: C

Rationale: The correct answer is C: Weakness and confusion. Hypoglycemia is characterized by low blood sugar levels, leading to inadequate glucose supply to the brain, resulting in symptoms like weakness and confusion. Choices A, B, and D are incorrect. Rapid, deep breathing is not typically a sign of hypoglycemia but can be seen in other conditions like respiratory issues. Increased urination is more commonly associated with conditions like diabetes mellitus, while high blood pressure is not a typical sign of hypoglycemia.

4. How should the nurse prepare a patient who is to receive a Schilling test for pernicious anemia?

• A. Administer radioactive cobalamin and measure its excretion time
• B. Measure antigen-antibody immune complexes
• C. Measure serum ferritin and total iron-binding capacity
• D. Administer folate and evaluate folate content in a blood serum sample

Correct answer: A

Rationale: The correct answer is A. To prepare a patient for a Schilling test for pernicious anemia, the nurse should administer radioactive cobalamin and measure its excretion time. This test is specifically designed to assess the absorption of vitamin B12. Choices B, C, and D are incorrect because they do not align with the preparation and procedure of a Schilling test. Measuring antigen-antibody immune complexes, serum ferritin, or total iron-binding capacity, as well as administering folate and evaluating folate content, are not part of the Schilling test protocol.

5. 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.

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