Nursing Elites

1. In emphysema, what features result in impaired oxygenation?

• A. The bronchioles are inflamed and filled with mucus
• B. The alveoli have lost surfactant and collapse
• C. Enlarged, permanently inflated alveoli
• D. The accumulation of purulent fluid in the bronchioles

Correct answer: C

Rationale: The correct answer is C. In emphysema, impaired oxygenation results from enlarged and permanently inflated alveoli, leading to reduced surface area for gas exchange. Choices A, B, and D are incorrect. In emphysema, bronchioles are not typically filled with mucus, alveoli losing surfactant and collapsing is more characteristic of conditions like atelectasis, and purulent fluid accumulation in the bronchioles is commonly seen in conditions like pneumonia, not emphysema.

2. A patient has been prescribed an estrogen-progestin oral contraceptive. The nurse should emphasize that the risk of thrombophlebitis is most likely in patients who:

• A. Are diabetic.
• B. Smoke cigarettes.
• C. Have a history of hypertension.
• D. Are older than 40.

Correct answer: B

Rationale: The correct answer is B: Smoke cigarettes. Smoking is a significant risk factor for thrombophlebitis, especially when combined with estrogen-progestin contraceptives. Choice A, being diabetic, does not directly increase the risk of thrombophlebitis in this context. Choice C, having a history of hypertension, is not a primary risk factor for thrombophlebitis. Choice D, being older than 40, is not the most likely factor associated with an increased risk of thrombophlebitis in patients taking estrogen-progestin oral contraceptives.

3. 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.

4. Peritonitis is a condition that can result in serious complications. Identify one of the complications.

• A. Increased peristalsis
• B. Dizziness and malaise
• C. Sepsis and shock
• D. Nausea and vomiting

Correct answer: C

Rationale: Corrected Rationale: Peritonitis can lead to severe complications such as sepsis and shock due to the infection spreading in the abdominal cavity. Sepsis is a systemic inflammatory response to infection, and shock is a life-threatening condition where the body's organs are not receiving enough blood flow. Choices A, B, and D are incorrect. Increased peristalsis is not a typical complication of peritonitis; dizziness and malaise, as well as nausea and vomiting, are symptoms rather than complications of the condition.

5. A patient with hypogonadism is being treated with testosterone gel. What application instructions should the nurse provide?

• A. Apply the gel to the face and neck for maximum absorption.
• B. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• C. Apply the gel to the genitals for improved results.
• D. Apply the gel to the scalp and back.

Correct answer: B

Rationale: The correct answer is B. Testosterone gel should be applied to the chest or upper arms and allowed to dry completely before dressing to avoid transfer to others. Applying the gel to the face, neck, genitals, scalp, or back is not recommended as these areas may lead to unintentional transfer to others, inappropriate absorption, or potential side effects. Choice A is incorrect as applying the gel to the face and neck can lead to unwanted transfer. Choice C is incorrect as applying the gel to the genitals is not the recommended site for application. Choice D is incorrect as the scalp and back are not appropriate sites for applying testosterone gel.

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