Nursing Elites

1. When a healthcare professional observes muscle stiffening occurring within 6 to 14 hours after death, the healthcare professional should document this finding as _____ present.

• A. Livor mortis
• B. Gangrene
• C. Algor mortis
• D. Rigor mortis

Correct answer: D

Rationale: The correct answer is D, Rigor mortis. Rigor mortis is the stiffening of muscles after death, typically beginning within 6 to 14 hours. Livor mortis (choice A) refers to the pooling of blood in the lowest tissues causing discoloration, gangrene (choice B) is the death of body tissue due to lack of blood flow, and algor mortis (choice C) is the cooling of the body after death.

2. What is the etiology and most likely treatment for myasthenia gravis in a 22-year-old female college student?

• A. Autoimmune destruction of skeletal muscle cells; treatment with intensive physical therapy and anabolic steroids.
• B. A decline in functioning acetylcholine receptors; treatment with corticosteroids and intravenous immunoglobulins.
• C. Cerebellar lesions; surgical and immunosuppressive treatment.
• D. Excess acetylcholinesterase production; treatment with thymectomy.

Correct answer: B

Rationale: Myasthenia gravis is characterized by a decline in functioning acetylcholine receptors rather than autoimmune destruction of skeletal muscle cells (Choice A), cerebellar lesions (Choice C), or excess acetylcholinesterase production (Choice D). The most likely treatment for myasthenia gravis involves corticosteroids to reduce inflammation and intravenous immunoglobulins to block the antibodies attacking acetylcholine receptors. Intensive physical therapy and anabolic steroids are not primary treatments for myasthenia gravis.

3. A nurse is teaching a class about immune deficiencies, and a person from the audience asks which cells are affected by severe combined immune deficiency (SCID) syndrome, and the nurse answers:

• A. B cell deficits
• B. T cell deficits
• C. Complement deficits
• D. B and T cell deficits

Correct answer: D

Rationale: The correct answer is D: B and T cell deficits. Severe combined immune deficiency (SCID) syndrome affects both B and T cells, leading to a severe impairment in the immune system's ability to fight infections. Choice A (B cell deficits) is incorrect because SCID affects not only B cells but also T cells. Choice B (T cell deficits) is incorrect as SCID is characterized by deficits in both B and T cells. Choice C (Complement deficits) is incorrect as SCID primarily involves B and T cell deficiencies rather than complement deficiencies.

4. Which of the following women are at highest risk for the development of endometrial cancer?

• A. A 50-year-old postmenopausal woman with a history of high-risk human papillomavirus
• B. A 45-year-old woman who is obese and has menstrual irregularities with periods of amenorrhea and infrequent periods.
• C. A 40-year-old woman who is overweight and has hypertension.
• D. A 55-year-old woman who smokes.

Correct answer: B

Rationale: The correct answer is B. Obesity and irregular menstrual cycles, including periods of amenorrhea and infrequent periods, are significant risk factors for the development of endometrial cancer. Choice A is less likely as postmenopausal status reduces the risk. Choice C is not directly associated with a high risk of endometrial cancer. Choice D, smoking, is more strongly linked to other types of cancers like lung cancer rather than endometrial cancer.

5. How does influenza immunization produce immunity?

• A. The virus from the vaccine remains in the body until the end of the season
• B. An attenuated virus causes immune system suppression and triggers immunity
• C. The body identifies the virus and develops antibodies against the virus
• D. The vaccine remains in the injection site and produces immune cells

Correct answer: C

Rationale: The correct answer is C. Influenza immunization works by introducing a weakened or inactivated form of the virus into the body, allowing the immune system to recognize it as foreign. This recognition triggers the production of antibodies specific to the virus. Choice A is incorrect as the virus in the vaccine does not remain in the body until the end of the season. Choice B is incorrect as an attenuated virus does not cause immune system suppression but rather stimulates an immune response. Choice D is incorrect because the vaccine does not stay at the injection site but rather prompts a systemic immune response throughout the body.

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