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 should the nurse teach the boy about anabolic steroid abuse?

• A. The ability of anabolic steroids to build muscle is greatly exaggerated in the media.
• B. Anabolic steroids are universally dangerous but are especially harmful to adolescents.
• C. The muscle mass resulting from steroid use will atrophy unless doses are continually increased.
• D. Anabolic steroids will reduce the boy's ability to perform weight-bearing exercise later in life.

Correct answer: B

Rationale: The correct answer is B because anabolic steroids are indeed universally dangerous, but they pose greater risks to adolescents due to their impact on growth and development. Choice A is incorrect because anabolic steroids do have the potential to build muscle mass, though not to the extent often portrayed in the media. Choice C is incorrect as muscle mass gained from steroid use may persist for a period even after discontinuation. Choice D is incorrect as anabolic steroids can enhance muscle performance initially, though long-term use can have adverse effects on health and not specifically on the ability to perform weight-bearing exercises.

3. In a patient with chronic kidney disease and a hemoglobin level of 9 g/dL, which of the following treatments is most appropriate?

• A. Iron supplementation
• B. Erythropoiesis-stimulating agents
• C. Blood transfusion
• D. Vitamin B12 supplementation

Correct answer: B

Rationale: In chronic kidney disease, anemia commonly occurs due to decreased erythropoietin production. Erythropoiesis-stimulating agents, such as erythropoietin or darbepoetin, are the mainstay of treatment to stimulate red blood cell production. Iron supplementation is more appropriate for iron-deficiency anemia, not the anemia of chronic kidney disease. Blood transfusion is reserved for severe cases or acute blood loss. Vitamin B12 supplementation is indicated for megaloblastic anemia caused by vitamin B12 deficiency, not specifically in chronic kidney disease-related anemia.

4. Which of the following is the most appropriate diagnostic method for identifying lung cancer in its early stages?

• A. CT scan
• B. MRI
• C. X-ray
• D. Biopsy

Correct answer: D

Rationale: A biopsy is the most appropriate method for diagnosing lung cancer in its early stages. A biopsy involves taking a small tissue sample from the lung for examination under a microscope. This method provides a definitive diagnosis by identifying cancerous cells. CT scans, MRIs, and X-rays can help detect abnormalities in the lungs, but a biopsy is necessary to confirm the presence of lung cancer. CT scans offer detailed images of the lung's structure, MRIs use magnetic fields for imaging soft tissues, and X-rays provide a basic view of the lungs, but none of these imaging techniques can definitively confirm the presence of cancer without a biopsy.

5. How does tamsulosin (Flomax) primarily benefit male patients with benign prostatic hyperplasia (BPH)?

• A. Relaxation of the muscles in the prostate and bladder neck, leading to improved urinary flow.
• B. Reduction in prostate size and improvement in urinary symptoms.
• C. Increase in urine flow and relief of urinary obstruction.
• D. Improvement in erectile function.

Correct answer: A

Rationale: The correct answer is A: Tamsulosin works by relaxing the muscles in the prostate and bladder neck, which helps improve urinary flow in patients with BPH. This relaxation reduces the symptoms associated with BPH, such as urinary hesitancy, urgency, and frequency. Choice B is incorrect because tamsulosin does not directly reduce the size of the prostate gland. Choice C is incorrect as while tamsulosin does improve urine flow, its primary mechanism of action is through muscle relaxation rather than directly relieving obstruction. Choice D is incorrect as tamsulosin is not indicated for improving erectile function; its main therapeutic effect is targeted towards urinary symptoms related to BPH.

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