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. What should the nurse emphasize regarding the risks associated with hormone replacement therapy (HRT) in a patient with a history of cardiovascular disease?

• A. HRT is associated with an increased risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may improve mood and energy levels.
• D. HRT may increase the risk of venous thromboembolism.

Correct answer: A

Rationale: The correct answer is A because hormone replacement therapy (HRT) is associated with an increased risk of cardiovascular events, including heart attack and stroke, particularly in patients with a history of cardiovascular disease. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; instead, it may have adverse effects on bone health. Choice C is incorrect as the improvement in mood and energy levels is not a significant risk associated with HRT. Choice D is incorrect because while HRT may increase the risk of venous thromboembolism, the question specifically focuses on patients with a history of cardiovascular disease, where the emphasis should be on cardiovascular risks.

3. A school nurse is meeting with a high school student who mentions that she is frustrated with her repeated outbreaks of cold sores. The student states that she tried an over-the-counter topical cream but that it failed to produce an appreciable improvement. The nurse should recognize that this student used what medication?

• A. Ganciclovir
• B. Valacyclovir (Valtrex)
• C. Famciclovir (Famvir)
• D. Docosanol (Abreva)

Correct answer: D

Rationale: The correct answer is D: Docosanol (Abreva). Docosanol is an over-the-counter topical cream commonly used to treat cold sores caused by the herpes simplex virus. It works by inhibiting viral fusion to host cell membranes, reducing the spread of the virus. Ganciclovir (Choice A) is an antiviral medication used for the treatment of cytomegalovirus infections. Valacyclovir (Choice B) and Famciclovir (Choice C) are prescription antiviral medications used to treat herpes simplex virus infections but are not typically available over-the-counter like Docosanol.

4. Which of the following findings is commonly associated with congestive heart failure?

• A. Decreased jugular venous pressure
• B. Pulmonary edema
• C. Hyperactive bowel sounds
• D. Weight loss

Correct answer: B

Rationale: Pulmonary edema is a common finding in congestive heart failure. In congestive heart failure, the heart is unable to pump effectively, leading to fluid buildup in the lungs, causing pulmonary edema. This results in symptoms like shortness of breath, coughing, and wheezing. Choices A, C, and D are not typically associated with congestive heart failure. Jugular venous pressure is often elevated, not decreased in heart failure. Hyperactive bowel sounds and weight loss are not specific findings for congestive heart failure.

5. A client has experienced a pontine stroke which has resulted in severe hemiparesis. What priority assessment should the nurse perform prior to allowing the client to eat or drink from the food tray?

• A. Evaluate the client's gag reflex.
• B. Assess the client's bowel sounds.
• C. Check the client's pupil reaction.
• D. Monitor the client's heart rate.

Correct answer: A

Rationale: The correct answer is to evaluate the client's gag reflex. When a client has experienced a stroke resulting in severe hemiparesis, assessing the gag reflex is crucial before allowing them to eat or drink. This assessment helps prevent aspiration, a serious complication that can occur due to impaired swallowing ability. Assessing bowel sounds (Choice B), pupil reaction (Choice C), or heart rate (Choice D) are important assessments but are not the priority in this situation where the risk of aspiration is higher.

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