Nursing Elites

1. What is the primary cause of primary hypercholesteremia?

• A. High-density lipoprotein (HDL) defects
• B. Monogenic mutations, sedentary lifestyle, and high cholesterol diet
• C. Polygenic mutations and environmental factors
• D. Low-density lipoprotein (LDL) receptor mutation with defects in breakdown

Correct answer: D

Rationale: The correct answer is 'Low-density lipoprotein (LDL) receptor mutation with defects in breakdown.' Primary hypercholesteremia is mainly caused by mutations in the LDL receptor, leading to impaired clearance of LDL cholesterol from the blood. This results in high levels of LDL cholesterol in the bloodstream. Choices A, B, and C are incorrect because they do not directly relate to the primary cause of primary hypercholesteremia.

2. During the home visit of a client with dementia, the nurse notes that an adult daughter persistently corrects her father’s misperceptions of reality, even when the father becomes upset and anxious. Which intervention should the nurse teach the caregiver?

• A. Anxiety-reducing measures
• B. Positive reinforcement
• C. Reality orientation techniques
• D. Validation techniques

Correct answer: D

Rationale: The correct answer is D: Validation techniques. In dementia care, using validation techniques involves acknowledging the person's feelings and reality, even if it differs from actual events or facts. It helps in reducing the client's anxiety and distress. In this scenario, the daughter persistently correcting her father's misperceptions can escalate his anxiety. Teaching the daughter validation techniques will encourage her to validate her father's feelings and perceptions, ultimately promoting a more supportive and less confrontational environment. Choices A, B, and C are incorrect in this context. While anxiety-reducing measures can be beneficial, the primary issue here is the father's misperceptions being consistently corrected. Positive reinforcement focuses on rewarding desired behaviors, which is not directly related to the situation described. Reality orientation techniques involve constantly reminding the person of the correct time, place, and other details, which may not be suitable for someone with dementia experiencing distress.

3. After studying about fungi, which information indicates a correct understanding of fungi? Fungi causing deep or systemic infections:

• A. Are easily treated with penicillin
• B. Are extremely rare
• C. Never occur with other infections
• D. Are commonly opportunistic

Correct answer: D

Rationale: The correct answer is D: 'Are commonly opportunistic.' Fungi causing deep or systemic infections are commonly opportunistic, particularly in individuals with compromised immune systems. Choice A is incorrect because fungi infections are not easily treated with penicillin. Choice B is incorrect as deep or systemic fungal infections are not extremely rare. Choice C is incorrect as fungal infections can co-occur with other infections.

4. A patient has been prescribed sildenafil (Viagra) for erectile dysfunction. What important information should the healthcare provider provide?

• A. This medication can cause sudden hearing loss.
• B. This medication should not be taken more than once a day.
• C. You should avoid taking this medication with high-fat meals.
• D. Avoid taking nitrates while on this medication.

Correct answer: D

Rationale: The correct answer is D. Sildenafil (Viagra) should not be taken with nitrates due to the risk of severe hypotension. Nitrates can potentiate the hypotensive effects of sildenafil, leading to a dangerous drop in blood pressure. Choice A is incorrect because sudden hearing loss is a rare but serious side effect associated with sildenafil, not a common side effect. Choice B is not the most important information related to sildenafil use. While it is generally recommended not to exceed one dose per day, the interaction with nitrates is more critical. Choice C is also important to consider as high-fat meals can delay the onset of action of sildenafil, but it is not as crucial as avoiding nitrates.

5. After teaching the students about B cells, which statement indicates teaching was successful? B cells are originally derived from cells of the:

• A. Bone marrow
• B. Lymph nodes
• C. Gut-associated lymphoid tissue
• D. Thymus

Correct answer: A

Rationale: The correct answer is A: Bone marrow. B cells are originally derived from cells of the bone marrow. Bone marrow is the primary site where B cells develop and mature. Lymph nodes (choice B), gut-associated lymphoid tissue (choice C), and the thymus (choice D) are involved in the immune response but are not the primary site of origin for B cells.

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