Nursing Elites

1. Which immunoglobulin presents the first challenge to the antigen?

• A. IgA
• B. IgG
• C. IgM
• D. IgE

Correct answer: C

Rationale: IgM is the first immunoglobulin to challenge the antigen during an immune response. IgM is the primary antibody produced during the initial or primary immune response. It is efficient in agglutination and complement activation, making it crucial in the early stages of defense. IgA is mainly found in mucosal areas and secretions. IgG is the most abundant antibody in circulation and is involved in secondary immune responses. IgE is primarily associated with allergic reactions and parasitic infections. Therefore, IgM is the correct choice as it acts first during the immune response, while the other immunoglobulins have different roles and functions.

2. A male patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What therapeutic effect is expected from this medication?

• A. Reduction in prostate size and improvement in urinary symptoms
• B. Increase in urine flow and relief of urinary obstruction
• C. Improvement in erectile function
• D. Relief of pain associated with BPH

Correct answer: A

Rationale: The correct answer is A: Reduction in prostate size and improvement in urinary symptoms. Finasteride works by reducing the size of the prostate gland, which in turn helps alleviate urinary symptoms such as frequency, urgency, weak stream, and incomplete emptying of the bladder. Choice B is incorrect as while finasteride can improve urine flow indirectly by reducing prostate size, it does not directly increase urine flow. Choice C is incorrect because finasteride is not intended to improve erectile function. Choice D is incorrect as finasteride does not primarily provide relief from pain associated with BPH.

3. What occurs in a client with polycythemia?

• A. Deficient plasma in the blood
• B. Increased lymphatic fluid being produced
• C. Increased red blood cells being produced
• D. Deficient number of red blood cells

Correct answer: C

Rationale: The correct answer is C: Increased red blood cells being produced. Polycythemia is a condition characterized by an elevated number of red blood cells in the blood. This increased concentration of red blood cells can lead to blood thickening and potentially result in complications such as blood clots. Choices A, B, and D are incorrect because polycythemia does not involve deficient plasma, increased lymphatic fluid production, or a deficient number of red blood cells.

4. A patient is starting on alendronate (Fosamax) for the treatment of osteoporosis. What instructions should the nurse provide to ensure the effectiveness of the medication?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Taking the medication with milk (choice B) is not recommended as it may interfere with alendronate absorption. Taking it at bedtime (choice C) is not necessary and may increase the risk of esophageal irritation. Taking the medication with food (choice D) can reduce its absorption and effectiveness.

5. A client with a history of chronic alcoholism presents to the emergency department with a complaint of double vision. Which cranial nerve is most likely involved?

• A. Cranial nerve I (Olfactory)
• B. Cranial nerve III (Oculomotor)
• C. Cranial nerve VI (Abducens)
• D. Cranial nerve VII (Facial)

Correct answer: C

Rationale: The correct answer is Cranial nerve VI (Abducens). Chronic alcoholism can lead to damage to the abducens nerve, which controls the lateral movement of the eye. This damage can result in symptoms like double vision. Cranial nerve I (Olfactory) is responsible for the sense of smell and is not related to eye movement. Cranial nerve III (Oculomotor) controls most of the eye movements but is less likely to be affected in chronic alcoholism than the abducens nerve. Cranial nerve VII (Facial) is responsible for facial movements and is not associated with double vision.

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