Nursing Elites

1. Which of the following is a common cause of secondary hypertension?

• A. Primary aldosteronism
• B. Essential hypertension
• C. White coat hypertension
• D. Prehypertension

Correct answer: A

Rationale: Primary aldosteronism is a common cause of secondary hypertension. In primary aldosteronism, there is an overproduction of aldosterone from the adrenal glands, leading to increased sodium retention and potassium excretion, ultimately resulting in high blood pressure. Essential hypertension (Choice B) is the most common type of hypertension, but it is considered primary hypertension, not secondary. White coat hypertension (Choice C) refers to elevated blood pressure readings in a clinical setting due to anxiety but not in daily life. Prehypertension (Choice D) is a condition where blood pressure levels are elevated but not high enough to be classified as hypertension.

2. When the maternal immune system becomes sensitized against antigens expressed by the fetus, what type of immune reaction occurs?

• A. Autoimmune
• B. Anaphylaxis
• C. Alloimmune
• D. Allergic

Correct answer: C

Rationale: When the maternal immune system becomes sensitized against antigens expressed by the fetus, an alloimmune reaction occurs. In this situation, the mother's immune system recognizes the fetus as foreign due to differences in antigens, leading to an immune response against the fetus. Choice A, 'Autoimmune,' is incorrect because it refers to the immune system mistakenly attacking the body's own cells and tissues. Choice B, 'Anaphylaxis,' is not the correct answer as it is a severe allergic reaction that can be life-threatening. Choice D, 'Allergic,' is also incorrect as it refers to an immune response triggered by allergens, not antigens expressed by the fetus.

3. A 21-year-old male is brought to the ED following a night of partying in his fraternity. His friends found him 'asleep' and couldn't get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the man's friends, the nurse begins by explaining that alcohol is:

• A. A water-soluble compound that is easily absorbed by the gastric lining of the stomach.
• B. Very lipid-soluble and rapidly crosses the blood–brain barrier.
• C. Able to reverse the transport of some substances to remove them from the brain.
• D. Very likely to cause sedation and therefore the client just needs to sleep it off.

Correct answer: B

Rationale: The correct answer is B. Alcohol is very lipid-soluble and rapidly crosses the blood–brain barrier, leading to its effects on the central nervous system and causing symptoms like sedation and unconsciousness. Choice A is incorrect because alcohol is not water-soluble; it is lipid-soluble. Choice C is incorrect as alcohol does not reverse the transport of substances from the brain. Choice D is incorrect as sedation from alcohol is not a reason to just 'sleep it off' in cases of alcohol poisoning, which can be life-threatening and requires medical attention.

4. Which of the following nonpharmacologic treatments is most likely to be a useful and appropriate supplement to pharmacologic analgesia at this point?

• A. Cognitive-behavioral therapy
• B. Cold and heat application
• C. Therapeutic ultrasound
• D. Biofeedback

Correct answer: B

Rationale: The correct answer is B: Cold and heat application. Cold and heat application are commonly used nonpharmacologic methods for managing pain and can complement pharmacologic treatments. Cold packs can help reduce inflammation and numb localized areas, while heat application can increase blood flow and relax muscles. Cognitive-behavioral therapy (A) focuses on changing negative thought patterns and behaviors to manage pain but may not directly supplement pharmacologic analgesia. Therapeutic ultrasound (C) uses sound waves to generate heat within body tissues, which can be therapeutic, but it may not be as directly complementary to pharmacologic analgesia as cold and heat application. Biofeedback (D) involves using electronic devices to help individuals control physiological processes, but its direct role as a supplement to pharmacologic analgesia may be less pronounced compared to cold and heat application.

5. A male patient is receiving testosterone therapy for hypogonadism. What adverse effect should the nurse be most concerned about?

• A. Increased risk of breast cancer
• B. Increased risk of liver dysfunction
• C. Increased risk of cardiovascular events
• D. Increased risk of prostate cancer

Correct answer: C

Rationale: The correct answer is C: Increased risk of cardiovascular events. Cardiovascular events such as stroke and myocardial infarction are the most concerning adverse effects of testosterone therapy, especially in older patients. Choice A, increased risk of breast cancer, is not a common adverse effect of testosterone therapy in males. Choice B, increased risk of liver dysfunction, is a potential adverse effect but is not the most concerning. Choice D, increased risk of prostate cancer, is a consideration in patients with a history of prostate cancer or those with prostate carcinoma, not typically in patients receiving testosterone therapy for hypogonadism.

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