Nursing Elites

1. 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.

2. What important information should the nurse provide about the risks associated with tamoxifen (Nolvadex) for a patient with a history of breast cancer?

• A. Tamoxifen may increase the risk of venous thromboembolism.
• B. Tamoxifen may decrease the risk of osteoporosis.
• C. Tamoxifen may cause hot flashes and other menopausal symptoms.
• D. Tamoxifen may cause weight gain and fluid retention.

Correct answer: A

Rationale: The correct answer is A: Tamoxifen may increase the risk of venous thromboembolism. Patients on tamoxifen should be educated about the signs and symptoms of blood clots. Choices B, C, and D are incorrect. Tamoxifen does not decrease the risk of osteoporosis; it may cause hot flashes and other menopausal symptoms, and it may cause weight gain and fluid retention.

3. An older adult patient has just sheared the skin on her elbow while attempting to boost herself up in bed, an event that has precipitated acute inflammation in the region surrounding the wound. Which of the following events will occur during the vascular stage of the patient's inflammation?

• A. Outpouring of exudate into interstitial spaces
• B. Chemotaxis
• C. Accumulation of leukocytes along epithelium
• D. Phagocytosis of cellular debris

Correct answer: A

Rationale: During the vascular stage of inflammation, there is an outpouring of exudate into the interstitial spaces, leading to swelling and edema. Choice B, chemotaxis, occurs during the cellular stage of inflammation, where leukocytes move to the site of injury in response to chemical signals. Choice C, accumulation of leukocytes along the epithelium, is not a typical event during the vascular stage. Phagocytosis of cellular debris, as in choice D, mainly occurs during the resolution stage of inflammation.

4. A child is experiencing difficulty with chewing and swallowing. The nurse knows that which cells may be innervating specialized gut-related receptors that provide taste and smell?

• A. Special somatic afferent fibers
• B. General somatic afferents
• C. Special visceral afferent cells
• D. General visceral afferent neurons

Correct answer: C

Rationale: The correct answer is C: Special visceral afferent cells. These cells are responsible for innervating taste and smell receptors related to the gut. Special somatic afferent fibers (choice A) are involved in sensations like touch and proprioception, not taste and smell. General somatic afferents (choice B) carry sensory information from the skin and musculoskeletal system, not taste and smell. General visceral afferent neurons (choice D) transmit sensory information from internal organs, but not specifically related to taste and smell sensations.

5. Which of the following findings is commonly associated with congestive heart failure?

• A. Decreased jugular venous pressure
• B. Pulmonary edema
• C. Hyperactive bowel sounds
• D. Weight loss

Correct answer: B

Rationale: Pulmonary edema is a common finding in congestive heart failure. In congestive heart failure, the heart is unable to pump effectively, leading to fluid buildup in the lungs, causing pulmonary edema. This results in symptoms like shortness of breath, coughing, and wheezing. Choices A, C, and D are not typically associated with congestive heart failure. Jugular venous pressure is often elevated, not decreased in heart failure. Hyperactive bowel sounds and weight loss are not specific findings for congestive heart failure.

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