Nursing Elites

1. Which of the following is not an autoimmune disease?

• A. Multiple sclerosis
• B. Pernicious anemia
• C. Goodpasture syndrome
• D. Transfusion reaction

Correct answer: D

Rationale: The correct answer is D, Transfusion reaction. Transfusion reaction is not an autoimmune disease because it occurs when the immune system responds to foreign blood cells, not to the body's own cells. Choices A, B, and C (Multiple sclerosis, Pernicious anemia, Goodpasture syndrome) are autoimmune diseases where the immune system mistakenly attacks the body's own tissues or organs.

2. When administering an immunization, which of the following medications should be available?

• A. Diphenhydramine (Benadryl)
• B. Hydroxyzine (Vistaril)
• C. Physostigmine
• D. Epinephrine

Correct answer: D

Rationale: When administering an immunization, it is essential to have epinephrine available in case of an allergic reaction such as anaphylaxis. Epinephrine is the medication of choice for treating severe allergic reactions due to its ability to reverse the symptoms rapidly. Diphenhydramine and hydroxyzine are antihistamines that can help manage mild allergic reactions but are not the primary medications for severe reactions like anaphylaxis. Physostigmine is not indicated for managing allergic reactions and is used for specific conditions such as anticholinergic toxicity.

3. A patient is being treated with hormone replacement therapy (HRT) for menopausal symptoms. What are the risks associated with long-term HRT that the nurse should discuss with the patient?

• A. HRT may increase the risk of cardiovascular events and breast cancer.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may increase the risk of venous thromboembolism.
• D. HRT may improve mood and energy levels.

Correct answer: A

Rationale: The correct answer is A. Long-term HRT is associated with increased risks of cardiovascular events and breast cancer. These risks should be discussed with the patient to ensure they are informed about the potential adverse effects. Choice B is incorrect because HRT does not decrease the risk of osteoporosis; in fact, it may increase the risk of certain conditions like cardiovascular events. Choice C is incorrect as HRT is associated with an increased risk of venous thromboembolism, not a decreased risk. Choice D is incorrect because while HRT may have positive effects like improving symptoms of menopause, it is not primarily indicated for improving mood and energy levels.

4. A male patient with erectile dysfunction is prescribed sildenafil (Viagra). What specific instruction should the nurse provide to ensure the safe use of this medication?

• A. Take the medication with food to prevent nausea.
• B. Avoid taking nitrates while on this medication.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with milk to enhance absorption.

Correct answer: B

Rationale: The correct instruction the nurse should provide is to avoid taking nitrates while on sildenafil (Viagra). Combining sildenafil with nitrates can result in severe hypotension due to additive vasodilatory effects. Choice A is incorrect because sildenafil can be taken with or without food. Choice C is incorrect as there is no specific requirement to take sildenafil at bedtime. Choice D is incorrect as taking sildenafil with milk has not been shown to enhance its absorption.

5. In emphysema, what features result in impaired oxygenation?

• A. The bronchioles are inflamed and filled with mucus
• B. The alveoli have lost surfactant and collapse
• C. Enlarged, permanently inflated alveoli
• D. The accumulation of purulent fluid in the bronchioles

Correct answer: C

Rationale: The correct answer is C. In emphysema, impaired oxygenation results from enlarged and permanently inflated alveoli, leading to reduced surface area for gas exchange. Choices A, B, and D are incorrect. In emphysema, bronchioles are not typically filled with mucus, alveoli losing surfactant and collapsing is more characteristic of conditions like atelectasis, and purulent fluid accumulation in the bronchioles is commonly seen in conditions like pneumonia, not emphysema.

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