Nursing Elites

1. Multiple sclerosis manifests as asymmetrical and in different parts of the body because:

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: A

Rationale: The correct answer is A. Multiple sclerosis is characterized by the immune system attacking the myelin sheath in the central nervous system. This attack leads to patchy damage on the myelin sheath, resulting in asymmetrical neurological symptoms. Choices B, C, and D are incorrect because they do not accurately describe the pathophysiology of multiple sclerosis. In multiple sclerosis, it is the autoreactive lymphocytes that target and damage the myelin sheath, not acetylcholine receptors, T lymphocytes, or cortical motor cells.

2. A staff member asks what leukocytosis means. How should the nurse respond? Leukocytosis can be defined as:

• A. A normal leukocyte count
• B. A high leukocyte count
• C. A low leukocyte count
• D. Another term for leukopenia

Correct answer: B

Rationale: Leukocytosis refers to an abnormally high leukocyte count. This condition is characterized by an elevated number of white blood cells in the bloodstream. Choice A is incorrect because leukocytosis does not refer to a normal leukocyte count. Choice C is incorrect as leukocytosis is not related to a low leukocyte count. Choice D is incorrect as leukopenia is the opposite of leukocytosis, indicating a low white blood cell count.

3. What causes type I diabetes?

• A. Overproduction of insulin from the beta cells of the pancreas
• B. Destruction of the beta cells within the pancreas, resulting in an inability to produce insulin
• C. Loss of insulin receptors on the target cells, resulting in insulin resistance
• D. A pituitary tumor in the brain, resulting in increased antidiuretic hormone production

Correct answer: B

Rationale: Type I diabetes is caused by the destruction of the beta cells in the pancreas, leading to an inability to produce insulin. This results in a lack of insulin, leading to hyperglycemia. Choice A is incorrect as type I diabetes is characterized by a deficiency of insulin production, not overproduction. Choice C describes the pathophysiology of type 2 diabetes, where insulin receptors become less responsive to insulin. Choice D is unrelated to type I diabetes as it describes a pituitary tumor causing increased antidiuretic hormone production.

4. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?

• A. History of peptic ulcer disease
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of hypertension

Correct answer: B

Rationale: The correct answer is B: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates combined with sildenafil can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of peptic ulcer disease, use of antihypertensive medications, or a history of hypertension are not direct contraindications for sildenafil use.

5. A male patient with hypogonadism is receiving testosterone therapy. What is the most serious adverse effect the nurse should monitor for?

• A. Increased risk of breast cancer
• B. Increased risk of cardiovascular events
• C. Increased risk of liver dysfunction
• D. Increased risk of prostate cancer

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Testosterone therapy can lead to an increased risk of cardiovascular events such as heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is crucial when administering testosterone therapy. Choices A, C, and D are incorrect because testosterone therapy does not typically lead to an increased risk of breast cancer, liver dysfunction, or prostate cancer.

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