Nursing Elites

1. When reviewing the purpose/action of neurotransmitters as they interact with different receptors, the nursing instructor gives an example using acetylcholine. When acetylcholine is released at the sinoatrial node in the right atrium of the heart, it is:

• A. positively charged.
• B. inhibitory.
• C. overstimulated.
• D. dormant.

Correct answer: B

Rationale: Acetylcholine acts as an inhibitory neurotransmitter at the sinoatrial node. It slows down the heart rate by decreasing the firing rate of the sinoatrial node, which serves as the heart's natural pacemaker. Neurotransmitters do not have a charge, so choice A is incorrect. Choice C is wrong as overstimulation is not a characteristic of acetylcholine at the sinoatrial node. Choice D is also incorrect because acetylcholine actively influences heart rate regulation when released at the sinoatrial node.

2. What physiological reaction occurs in the body with the 'Fight or flight' response?

• A. Increased heart rate
• B. Constricted pupils
• C. Decreased blood pressure
• D. Decreased heart rate

Correct answer: A

Rationale: The 'fight or flight' response is a primal physiological reaction that prepares the body to respond to a perceived threat or danger. This response triggers an increase in heart rate to pump more blood to the muscles and vital organs, preparing the body for action. Choice B, 'Constricted pupils,' is part of the 'fight or flight' response as well, as it helps improve focus and vision. Choice C, 'Decreased blood pressure,' is incorrect because blood pressure typically increases to ensure adequate circulation during the 'fight or flight' response. Choice D, 'Decreased heart rate,' is incorrect as the heart rate increases to supply more oxygen and nutrients to the body during times of stress.

3. A healthcare provider is explaining to a patient the difference between primary and secondary immunodeficiency disorders and explains that secondary immunodeficiencies (select ONE that does not apply):

• A. May develop after viral infections
• B. Develop before birth
• C. May develop following immunosuppressive therapies
• D. Are caused by superimposed conditions

Correct answer: B

Rationale: The correct statements about secondary immunodeficiencies are that they may develop after viral infections, following immunosuppressive therapies, and are caused by superimposed conditions. Choice B ('Develop before birth') is incorrect because secondary immunodeficiencies do not develop before birth. They are acquired later in life. Therefore, the correct answers are A, C, and D.

4. A 20-year-old college student has presented to her campus medical clinic for a scheduled Pap smear. The clinician who will interpret the smear will examine cell samples for evidence of:

• A. Changes in cell shape, size, and organization
• B. Presence of unexpected cell types
• C. Ischemic changes in cell sample
• D. Abnormally high numbers of cells

Correct answer: A

Rationale: The correct answer is changes in cell shape, size, and organization (Choice A). Pap smears are performed to detect potential precancerous or cancerous conditions by examining the cells for any abnormalities in their shape, size, or organization. This helps in identifying early signs of cervical cancer. Choices B, C, and D are incorrect because Pap smears primarily focus on detecting cellular changes associated with cancer, not unexpected cell types, ischemic changes, or abnormally high numbers of cells.

5. A client with chronic bronchitis is receiving education from a healthcare provider about the condition. Which statement made by the client indicates a need for further teaching?

• A. I should avoid being around people who smoke.
• B. I should try to avoid any exposure to pollutants and irritants.
• C. I should limit my fluid intake to avoid worsening my cough.
• D. I should use my inhaler regularly, even when I don't have symptoms.

Correct answer: C

Rationale: The correct answer is C because limiting fluid intake is not recommended for chronic bronchitis. Hydration is essential as it helps thin mucus, making it easier to clear from the airways. Choices A, B, and D are all correct statements for managing chronic bronchitis. Avoiding exposure to smoke, pollutants, and irritants can help reduce respiratory symptoms and exacerbations. Using the inhaler regularly, even in the absence of symptoms, is crucial for controlling inflammation and maintaining airway function.

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