Nursing Elites

1. Which of the following are characteristic, localized cardinal signs of acute inflammation? (Select ONE that does not apply.)

• A. Redness
• B. Fatigue
• C. Swelling
• D. Warmth

Correct answer: B

Rationale: The correct answers are A, C, and D. Redness, swelling, and warmth are classic signs of acute inflammation. Redness occurs due to increased blood flow, swelling is caused by leakage of fluid into tissues, and warmth is due to the vasodilation and increased blood flow in the affected area. Fatigue is not a cardinal sign of acute inflammation and is not directly associated with the inflammatory response.

2. Helicobacter pylori (H. pylori) often causes which of the following?

• A. Colon cancer
• B. Hiatal hernia
• C. Peptic ulcer disease
• D. Esophageal varices

Correct answer: C

Rationale: Helicobacter pylori is a bacterium known to cause peptic ulcer disease by weakening the protective lining of the stomach and duodenum, leading to inflammation and ulcers. While chronic H. pylori infection is a risk factor for stomach cancer, it is not directly linked to colon cancer (Choice A), hiatal hernia (Choice B), or esophageal varices (Choice D). Therefore, the correct answer is C.

3. A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What specific instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. This positioning helps reduce the risk of esophageal irritation and ensures adequate drug absorption. Choice B is incorrect because alendronate should be taken with water, not milk. Choice C is incorrect as there is no specific advantage to taking alendronate at bedtime. Choice D is incorrect because taking alendronate with food may interfere with its absorption.

4. Abrupt withdrawal or discontinuation of prednisone can cause:

• A. adrenal crisis.
• B. hypercortisolism.
• C. ACTH stimulation.
• D. thyroid crisis.

Correct answer: A

Rationale: The correct answer is A: adrenal crisis. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, resulting in adrenal crisis. Prednisone is a corticosteroid that suppresses the adrenal glands' ability to produce cortisol. Abrupt withdrawal can cause a sudden drop in cortisol levels, leading to adrenal crisis with symptoms like fatigue, weakness, abdominal pain, and potentially life-threatening low blood pressure. Choices B, C, and D are incorrect because hypercortisolism refers to excess cortisol levels, ACTH stimulation would not result from prednisone withdrawal, and thyroid crisis is not directly related to corticosteroid discontinuation.

5. A patient presents with a chronic cough, night sweats, and weight loss. A chest X-ray reveals upper lobe cavitary lesions. Which of the following is the most likely diagnosis?

• A. Tuberculosis
• B. Pneumonia
• C. Lung cancer
• D. Sarcoidosis

Correct answer: A

Rationale: The correct answer is A: Tuberculosis. Cavitary lesions in the upper lobes are classic findings seen in tuberculosis. This infectious disease commonly presents with symptoms such as chronic cough, night sweats, and weight loss. Pneumonia (Choice B) typically does not present with cavitary lesions on chest X-ray. Lung cancer (Choice C) may present with similar symptoms but is less likely to cause cavitary lesions in the upper lobes. Sarcoidosis (Choice D) usually presents with bilateral hilar lymphadenopathy and non-caseating granulomas, different from the cavitary lesions described in the case.

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