Nursing Elites

1. Which information would indicate more teaching is needed regarding hypersensitivity reactions? Type _______ hypersensitivity reactions involve an antibody response.

• A. I
• B. II
• C. III
• D. IV

Correct answer: D

Rationale: The correct answer is D: Type IV hypersensitivity reactions involve cell-mediated immunity, not an antibody response. This question tests knowledge of hypersensitivity reactions and their classification. Type I hypersensitivity reactions involve IgE antibodies, Type II involves IgG or IgM antibodies, and Type III involves immune complex deposition. Type IV hypersensitivity reactions are delayed and involve T cells, not antibodies. Therefore, if a person believes that Type IV hypersensitivity reactions involve an antibody response, more teaching is required.

2. Multiple sclerosis manifests as asymmetrical and in different parts of the body because:

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: A

Rationale: The correct answer is A. Multiple sclerosis is characterized by the immune system attacking the myelin sheath in the central nervous system. This attack leads to patchy damage on the myelin sheath, resulting in asymmetrical neurological symptoms. Choices B, C, and D are incorrect because they do not accurately describe the pathophysiology of multiple sclerosis. In multiple sclerosis, it is the autoreactive lymphocytes that target and damage the myelin sheath, not acetylcholine receptors, T lymphocytes, or cortical motor cells.

3. A nurse is teaching a class about immune deficiencies, and a person from the audience asks which cells are affected by severe combined immune deficiency (SCID) syndrome, and the nurse answers:

• A. B cell deficits
• B. T cell deficits
• C. Complement deficits
• D. B and T cell deficits

Correct answer: D

Rationale: The correct answer is D: B and T cell deficits. Severe combined immune deficiency (SCID) syndrome affects both B and T cells, leading to a severe impairment in the immune system's ability to fight infections. Choice A (B cell deficits) is incorrect because SCID affects not only B cells but also T cells. Choice B (T cell deficits) is incorrect as SCID is characterized by deficits in both B and T cells. Choice C (Complement deficits) is incorrect as SCID primarily involves B and T cell deficiencies rather than complement deficiencies.

4. The signs of thyroid crisis resulting from Graves' disease include:

• A. constipation with gastric distension.
• B. bradycardia and bradypnea.
• C. hyperthermia and tachycardia.
• D. constipation and lethargy.

Correct answer: C

Rationale: Thyroid crisis in Graves' disease typically presents with hyperthermia (high body temperature) and tachycardia (rapid heart rate). These symptoms are a result of excessive thyroid hormone production and can lead to life-threatening complications if not promptly addressed. Choices A, B, and D are incorrect because constipation with gastric distension, bradycardia and bradypnea, and constipation and lethargy are not typical signs of a thyroid crisis in Graves' disease.

5. A patient has been prescribed an estrogen-progestin oral contraceptive. The nurse should emphasize that the risk of thrombophlebitis is most likely in patients who:

• A. Are diabetic.
• B. Smoke cigarettes.
• C. Have a history of hypertension.
• D. Are older than 40.

Correct answer: B

Rationale: The correct answer is B: Smoke cigarettes. Smoking is a significant risk factor for thrombophlebitis, especially when combined with estrogen-progestin contraceptives. Choice A, being diabetic, does not directly increase the risk of thrombophlebitis in this context. Choice C, having a history of hypertension, is not a primary risk factor for thrombophlebitis. Choice D, being older than 40, is not the most likely factor associated with an increased risk of thrombophlebitis in patients taking estrogen-progestin oral contraceptives.

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