Nursing Elites

1. When caring for a patient with systemic lupus erythematosus (SLE), the disease the nurse is dealing with is an example of:

• A. Autoimmunity
• B. Alloimmunity
• C. Homoimmunity
• D. Alleimmunity

Correct answer: A

Rationale: When a nurse cares for a patient with systemic lupus erythematosus (SLE), the nurse is dealing with an autoimmune disease. In autoimmune diseases like SLE, the immune system mistakenly attacks the body's own tissues. Choice A, 'Autoimmunity,' is the correct answer because SLE is an example of the immune system attacking self-antigens, leading to tissue damage and inflammation. Choices B, C, and D are incorrect. Alloimmunity refers to the immune response against foreign antigens from members of the same species, homoimmunity is not a recognized term in immunology, and alleimmunity is not a valid term in this context.

2. A patient with breast cancer is prescribed tamoxifen (Nolvadex). What should the nurse emphasize during patient education?

• A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be aware of the signs and symptoms of blood clots.
• B. Tamoxifen may cause weight gain, so patients should monitor their diet.
• C. Tamoxifen may cause hot flashes and other menopausal symptoms.
• D. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.

Correct answer: A

Rationale: The correct answer is A. Tamoxifen increases the risk of venous thromboembolism, a serious side effect. Therefore, patients should be educated about the signs and symptoms of blood clots, such as swelling, pain, and redness in the legs, and advised to seek immediate medical attention if they occur. Choice B is incorrect because weight gain is not a significant side effect of tamoxifen. Choice C is incorrect because hot flashes and menopausal symptoms are common side effects of tamoxifen but are not as critical to address as venous thromboembolism. Choice D is incorrect because tamoxifen does not decrease the risk of osteoporosis; in fact, it may increase the risk of bone loss in premenopausal women.

3. A client with chronic obstructive pulmonary disease (COPD) is admitted to the hospital for pneumonia. Which intervention should the nurse prioritize?

• A. Administer bronchodilators as prescribed.
• B. Monitor oxygen saturation levels continuously.
• C. Administer intravenous antibiotics as prescribed.
• D. Provide respiratory therapy treatments as needed.

Correct answer: C

Rationale: Administering IV antibiotics is crucial for treating pneumonia in a client with COPD. Pneumonia is an infection of the lungs that requires prompt antibiotic therapy to prevent complications and improve outcomes. While bronchodilators may help with COPD symptoms, in the case of pneumonia, addressing the infection is the priority. Continuous monitoring of oxygen saturation is important, but administering antibiotics to treat the underlying infection takes precedence. Respiratory therapy treatments can be beneficial, but they are not the initial priority when managing pneumonia in a client with COPD.

4. Multiple sclerosis manifests as asymmetrical and in different parts of the body because:

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: A

Rationale: The correct answer is A. Multiple sclerosis is characterized by the immune system attacking the myelin sheath in the central nervous system. This attack leads to patchy damage on the myelin sheath, resulting in asymmetrical neurological symptoms. Choices B, C, and D are incorrect because they do not accurately describe the pathophysiology of multiple sclerosis. In multiple sclerosis, it is the autoreactive lymphocytes that target and damage the myelin sheath, not acetylcholine receptors, T lymphocytes, or cortical motor cells.

5. Where are most body fluids located?

• A. Intravascular space.
• B. Intracellular space.
• C. Extracellular space.
• D. Transcellular space.

Correct answer: B

Rationale: Most body fluids are located within cells in the intracellular space. While the extracellular space also contains body fluids, the majority is found within the cells. Intravascular space refers to fluids within blood vessels, and transcellular space includes fluids in compartments like cerebrospinal, pleural, and peritoneal cavities.

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