Nursing Elites

1. Which condition is characterized by a progressive loss of muscle strength due to an autoimmune attack on acetylcholine receptors?

• A. Myasthenia gravis
• B. Multiple sclerosis
• C. Amyotrophic lateral sclerosis
• D. Guillain-Barré syndrome

Correct answer: A

Rationale: The correct answer is A: Myasthenia gravis. Myasthenia gravis is characterized by muscle weakness caused by autoimmune attack on acetylcholine receptors at the neuromuscular junction. This results in impaired communication between nerves and muscles. Choice B, Multiple sclerosis, is a condition where the immune system attacks the protective myelin sheath covering the nerves in the central nervous system, leading to communication issues between the brain and the rest of the body. Choice C, Amyotrophic lateral sclerosis, is a progressive neurodegenerative disease affecting motor neurons in the brain and spinal cord, not involving acetylcholine receptors. Choice D, Guillain-Barré syndrome, is an acute condition where the immune system attacks the peripheral nerves, causing muscle weakness and paralysis, but it does not target acetylcholine receptors.

2. Patients are coming into the emergency room as a result of an apartment house fire. You are examining a patient who is in distress but has no visible burn marks. You suspect that she is suffering from inhalation burns. Which of the following signs would NOT be associated with inhalation burns?

• A. Singed nasal hairs
• B. Conjunctivitis
• C. Hoarseness
• D. Clear sputum

Correct answer: D

Rationale: Clear sputum would not be associated with inhalation burns. Inhalation burns typically present with symptoms like singed nasal hairs, conjunctivitis, hoarseness, and possibly soot in sputum due to smoke inhalation. Clear sputum suggests that there is no significant inflammation or injury to the respiratory tract, which is not consistent with the typical findings in inhalation burns. The other choices are associated with inhalation burns: singed nasal hairs can occur due to exposure to hot air or gases, conjunctivitis can result from irritating substances in smoke, and hoarseness can be due to airway irritation.

3. Which intervention is most appropriate when caring for a patient experiencing a tonic-clonic seizure?

• A. Restrain the patient to prevent injury
• B. Place a tongue depressor in the patient's mouth
• C. Turn the patient to the side to maintain an open airway
• D. Attempt to stop the seizure by holding the patient’s arms

Correct answer: C

Rationale: During a tonic-clonic seizure, the priority is to ensure patient safety by maintaining an open airway to prevent aspiration. Turning the patient to the side helps achieve this goal by allowing any fluids to drain out of the mouth, reducing the risk of choking or aspiration. Restraint can lead to injury, placing a tongue depressor can cause harm or obstruct the airway further, and attempting to stop the seizure by holding the patient's arms is ineffective and can also result in injury. Therefore, the most appropriate intervention is to turn the patient to the side.

4. When a woman in early pregnancy is leaving the clinic, she blushes and asks the nurse if it is true that sex during pregnancy is bad for the baby. What is the best response for the nurse to give?

• A. The baby is protected by the sac. Sex is perfectly alright.
• B. It is unlikely to harm the baby. What you do with your personal life is your concern.
• C. Intercourse during pregnancy is usually alright, but you need to ask the doctor if it is acceptable for you.
• D. In a normal pregnancy, intercourse will not harm the baby. However, many women experience a change in desire. How are you feeling?

Correct answer: D

Rationale: Choice D is the best response as it reassures the patient that intercourse in a normal pregnancy will not harm the baby. It also shows empathy by acknowledging that many women experience changes in sexual desire during pregnancy. This response validates the patient's concerns and opens up a dialogue about her feelings. Choice A is incorrect as it lacks information about changes in sexual desire and oversimplifies the situation. Choice B is dismissive of the patient's concerns and does not provide adequate information. Choice C is not the best response as it suggests asking the doctor without offering immediate reassurance or addressing the patient's worries.

5. A female Native American client who is receiving chemotherapy places a native artifact, an Indian medicine wheel, in her hospital room. The HCP removes the medicine wheel and tells the client, 'This type of thing does not belong in the hospital.' Which intervention should the PN implement?

• A. Teach the client about the importance of adhering to the chemotherapy regimen
• B. Act as the client's advocate when addressing the issue with the HCP
• C. Consult with a Native American healer about the appropriate use of a medicine wheel
• D. Inform the HCP about the client's feelings of culture shock

Correct answer: B

Rationale: Acting as the client's advocate is the most appropriate intervention in this situation. Removing a culturally significant artifact without considering the client's beliefs and emotional needs can be distressing. By advocating for the client, the PN can ensure that the client's cultural practices are respected, which is crucial for her emotional and spiritual well-being during treatment. Choice A is incorrect because while chemotherapy adherence is important, it is not the most immediate concern in this scenario. The client's cultural needs and well-being take precedence. Choice C is incorrect because consulting with a Native American healer might not be necessary at this point and could delay addressing the immediate issue of advocating for the client's rights. Choice D is incorrect because simply reporting the client's feelings of culture shock to the HCP does not actively address the situation or advocate for the client's rights and cultural needs.

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