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. In which patient is alpha-1 antitrypsin deficiency the likely cause of chronic obstructive pulmonary disease?

• A. A 30-year-old who has smoked for 3 years
• B. A 65-year-old man who drove a taxi most of his life
• C. A 70-year-old woman who smoked for 40 years
• D. A 50-year-old with exposure to secondhand smoke

Correct answer: A

Rationale: Alpha-1 antitrypsin deficiency is a genetic cause of chronic obstructive pulmonary disease (COPD). It is more common in younger patients with a history of smoking at a younger age, like the 30-year-old who has smoked for 3 years. Choices B, C, and D are less likely to be associated with alpha-1 antitrypsin deficiency as COPD in these cases is more likely due to smoking and environmental exposures.

3. A patient with osteoporosis is prescribed raloxifene (Evista). What is the primary therapeutic action of this medication?

• A. It decreases bone resorption and increases bone density.
• B. It stimulates the formation of new bone.
• C. It increases calcium absorption in the intestines.
• D. It increases the excretion of calcium through the kidneys.

Correct answer: A

Rationale: The correct answer is A. Raloxifene works by decreasing bone resorption and increasing bone density. This helps in preventing further bone loss and reducing the risk of fractures in patients with osteoporosis. Choice B is incorrect because raloxifene does not stimulate the formation of new bone, but rather helps to maintain existing bone mass. Choice C is incorrect as raloxifene does not directly increase calcium absorption in the intestines. Choice D is also incorrect as raloxifene does not increase the excretion of calcium through the kidneys.

4. What are the major mechanisms of spinal cord injuries?

• A. Hypoextension, expansion, hyperflexion
• B. Hyperflexion, expansion, hypometabolism
• C. Hypermetabolism, compression, hyperextension
• D. Hyperextension, hyperflexion, compression

Correct answer: D

Rationale: The correct answer is D. Spinal cord injuries commonly occur due to hyperextension, hyperflexion, and compression. Hyperextension and hyperflexion refer to the excessive bending or stretching of the spinal cord, while compression is the exertion of pressure on the spinal cord. These mechanisms can lead to damage such as contusions, lacerations, and compression of the spinal cord. Choices A, B, and C are incorrect as they do not accurately represent the major mechanisms of spinal cord injuries.

5. What is the most sensitive indicator of altered brain function?

• A. The ability to perform complex mathematics
• B. Altered level of consciousness
• C. The lack of cerebrospinal fluid production
• D. Intact cranial nerve functions

Correct answer: B

Rationale: The correct answer is B: Altered level of consciousness. Changes in consciousness are the most sensitive indicator of altered brain function as they can signal underlying neurological issues. Option A, the ability to perform complex mathematics, though it involves brain function, is not as sensitive or direct an indicator as altered consciousness. Option C, the lack of cerebrospinal fluid production, is more related to conditions like hydrocephalus rather than a direct indicator of altered brain function. Option D, intact cranial nerve functions, indicate the normal functioning of peripheral nerves and are not as sensitive to changes in brain function as alterations in consciousness.

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