Nursing Elites

1. Which immunoglobulin is the first to appear in response to a new antigen?

• A. IgA
• B. IgG
• C. IgE
• D. IgM

Correct answer: D

Rationale: The correct answer is IgM. IgM is the first immunoglobulin to appear in response to a new antigen. It is produced initially during the primary immune response. IgA is mainly found in mucosal areas and secretions. IgG is produced in a secondary immune response and is the most abundant immunoglobulin in the bloodstream. IgE is involved in allergic reactions and parasitic infections, not the initial response to a new antigen.

2. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What important contraindication should the nurse emphasize during patient education?

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

Correct answer: A

Rationale: The correct answer is A: 'Use of nitrates.' Sildenafil (Viagra) is contraindicated in patients using nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because they are not direct contraindications for sildenafil use. While a history of hypertension or peptic ulcer disease may require caution, they are not absolute contraindications like the concomitant use of nitrates.

3. A patient is receiving finasteride (Proscar) for the treatment of benign prostatic hyperplasia. Which of the following is an expected outcome of the medication?

• A. Decrease in the size of the prostate gland.
• B. Improved urinary flow and decreased symptoms of urinary retention.
• C. Increased production of prostate-specific antigen (PSA).
• D. Reduction in the number of nocturnal awakenings.

Correct answer: B

Rationale: The correct answer is B. Finasteride (Proscar) is used in the treatment of benign prostatic hyperplasia to improve urinary flow and decrease symptoms of urinary retention by reducing the size of the prostate gland. Choice A is incorrect because although finasteride may reduce the size of the prostate gland, the expected outcome relevant to the patient's symptoms is improved urinary flow rather than a specific change in gland size. Choice C is incorrect because finasteride actually decreases the production of prostate-specific antigen (PSA) due to its mechanism of action. Choice D is incorrect because although improved urinary flow may lead to a reduction in nocturnal awakenings, the main expected outcome of finasteride treatment is related to urinary symptoms.

4. Which of the following is found in clients with Parkinson’s disease?

• A. Mobility and functioning
• B. The liver and kidneys
• C. Too much dopamine in the brain
• D. Skeletal muscle flaccidity

Correct answer: C

Rationale: The correct answer is C: Too much dopamine in the brain. Parkinson's disease is characterized by a deficiency of dopamine in the brain, not an excess. This deficiency leads to the motor symptoms associated with the disease. Choices A, B, and D are incorrect. Mobility and functioning are affected in Parkinson's disease due to the lack of dopamine, not an excess. The liver and kidneys are not directly related to Parkinson's disease. Skeletal muscle flaccidity is not typically a primary symptom of Parkinson's disease, which is more characterized by rigidity and tremors.

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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