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. In a postmenopausal woman, what condition can be prevented by administering estradiol (Estraderm)?

• A. Endometriosis
• B. Amenorrhea
• C. Osteoporosis
• D. Uterine cancer

Correct answer: C

Rationale: The correct answer is C: Osteoporosis. Estradiol, a form of estrogen, is used to prevent osteoporosis in postmenopausal women by maintaining bone density. Choice A, Endometriosis, is incorrect as estradiol is not used to prevent or treat this condition. Choice B, Amenorrhea, is not prevented by estradiol but rather may result from hormonal changes. Choice D, Uterine cancer, is not directly prevented by estradiol; in fact, long-term unopposed estrogen use can increase the risk of uterine cancer.

3. Which patient is most likely to be diagnosed with complex regional pain syndrome II (CRPS II)?

• A. A patient who has experienced a spinal cord injury and reports severe, burning pain in his legs.
• B. A patient who reports severe pain in her hand following a surgery for carpal tunnel syndrome.
• C. A patient who develops pain in his foot following a fracture and immobilization with a cast.
• D. A patient who experiences chronic pain and swelling in his arm following a brachial plexus injury.

Correct answer: D

Rationale: Complex regional pain syndrome II (CRPS II) typically occurs after an injury to a peripheral nerve. In this case, a brachial plexus injury involves damage to the nerves that control muscles in the arm and hand, leading to chronic pain and swelling. Choices A, B, and C describe pain related to other conditions such as spinal cord injury, carpal tunnel surgery, and fracture immobilization, which are not typically associated with CRPS II.

4. When the body produces antibodies against its own tissue, the condition is called

• A. Alloimmunity
• B. Opsonization
• C. Autoimmunity
• D. Hypersensitivity

Correct answer: C

Rationale: The correct answer is C, autoimmunity. Autoimmunity refers to the immune system attacking the body's own tissues. Alloimmunity (choice A) is the immune response to tissues of another individual of the same species. Opsonization (choice B) is the process where pathogens are marked for destruction by immune cells. Hypersensitivity (choice D) refers to excessive or inappropriate immune responses.

5. During surgery, the anesthesia personnel notice the client is having a steady rise in end-tidal carbon dioxide level. At this time, the nurse anesthetist begins to assess the client for malignant hyperthermia. The initial (priority) assessment for this disorder may include:

• A. measuring serum potassium levels.
• B. monitoring for muscle rigidity.
• C. evaluating renal function.
• D. checking arterial blood gases.

Correct answer: B

Rationale: The correct answer is B: monitoring for muscle rigidity. Muscle rigidity is a hallmark sign of malignant hyperthermia, a life-threatening condition triggered by certain anesthetics. Monitoring for this sign is critical in the early identification of the condition. Choices A, C, and D are not the initial priority assessments for malignant hyperthermia. Measuring serum potassium levels, evaluating renal function, and checking arterial blood gases are not specific initial assessments for malignant hyperthermia and would not aid in its early identification.

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