Nursing Elites

1. What pathophysiological events occur sequentially in the development of atherosclerosis?

• A. Foam cells release growth factors.
• B. Smooth muscle grows over fatty streaks creating fibrous plaques.
• C. Macrophages consume low-density lipoprotein (LDL) and create foam cells.
• D. Arterial endothelium injury causes inflammation.

Correct answer: D

Rationale: The correct sequence of pathophysiological events in the development of atherosclerosis starts with arterial endothelium injury causing inflammation. This inflammation triggers the formation of foam cells by macrophages consuming low-density lipoprotein (LDL). Subsequently, smooth muscle grows over fatty streaks, creating fibrous plaques. Therefore, option D is the correct answer. Choices A, B, and C are incorrect because they do not reflect the accurate chronological order of events in the pathogenesis of atherosclerosis.

2. What is the expected outcome of prescribing a proton pump inhibitor to a client with a peptic ulcer?

• A. Promote healing of the gastric mucosa.
• B. Neutralize the effects of stomach acid.
• C. Inhibit the growth of Helicobacter pylori.
• D. Reduce gastric acid secretion.

Correct answer: D

Rationale: The correct answer is D: Reduce gastric acid secretion. Proton pump inhibitors (PPIs) work by reducing gastric acid secretion, which helps prevent further irritation of the gastric mucosa and allows ulcers to heal. While promoting healing of the gastric mucosa (Choice A) is an indirect outcome of reducing gastric acid secretion, the primary mechanism of PPIs is to lower acid levels. Choice B, neutralizing the effects of stomach acid, is typically associated with antacids, not PPIs. Inhibiting the growth of Helicobacter pylori (Choice C) is usually achieved with antibiotics, not PPIs.

3. The client with a below-the-knee amputation is being taught about proper care of the residual limb. The most important point to emphasize would be

• A. Wrap the stump with an elastic bandage to prevent swelling
• B. Keep the skin on the stump clean and dry
• C. Use alcohol to cleanse the stump daily
• D. Apply moisturizing lotion to the stump daily

Correct answer: B

Rationale: The correct answer is B: Keep the skin on the stump clean and dry. This is crucial for preventing infection and promoting healing of the residual limb. Wrapping the stump with an elastic bandage can constrict blood flow and cause issues. Using alcohol to cleanse the stump daily can be too harsh and drying for the skin, leading to irritation. Applying moisturizing lotion daily is not as essential as keeping the skin clean and dry to prevent complications.

4. A client is prescribed an inhaled corticosteroid for asthma management. Which instruction should the nurse provide to the client regarding the use of this medication?

• A. Rinse your mouth after using the inhaler
• B. Hold your breath for 5 seconds after inhaling the medication
• C. Use the inhaler during an acute asthma attack
• D. Take the medication only when symptoms occur

Correct answer: A

Rationale: The correct instruction for a client using an inhaled corticosteroid for asthma management is to rinse the mouth after using the inhaler. This helps prevent oral thrush, a common side effect of corticosteroid inhalers. Holding the breath for 5 seconds after inhaling the medication (Choice B) is not necessary for corticosteroid inhalers. Using the inhaler during an acute asthma attack (Choice C) is not the purpose of corticosteroids, which are used for long-term asthma management. Taking the medication only when symptoms occur (Choice D) is not correct as corticosteroids are typically used regularly to control asthma symptoms.

5. A client with diabetes insipidus is admitted due to a pituitary tumor. What complication should the nurse monitor closely?

• A. Monitor for elevated blood pressure.
• B. Monitor for ketonuria.
• C. Monitor for peripheral edema.
• D. Monitor for hypokalemia.

Correct answer: D

Rationale: The correct answer is to monitor for hypokalemia. In diabetes insipidus, excessive urination can lead to electrolyte imbalances, particularly low potassium levels (hypokalemia). The loss of potassium through increased urination can result in muscle weakness, cardiac dysrhythmias, and other serious complications. Elevated blood pressure (Choice A) is not a typical complication of diabetes insipidus due to pituitary tumors. Ketonuria (Choice B) is more commonly associated with diabetes mellitus due to inadequate insulin levels. Peripheral edema (Choice C) is not a direct complication of diabetes insipidus.

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