Nursing Elites

1. Which of the following is NOT an example of clinical manifestations of leukemia and lymphoma?

• A. Fatigue
• B. Increased risk of bleeding
• C. Increased risk of infections
• D. Increased energy and strength

Correct answer: D

Rationale: The correct answer is D: Increased energy and strength. Leukemia and lymphoma typically present with symptoms such as fatigue, weakness, increased risk of bleeding, and increased risk of infections. Patients with these conditions often experience a lack of energy and strength due to the disease's impact on the body. Therefore, increased energy and strength are not typical manifestations of leukemia and lymphoma.

2. A 5-year-old female takes a hike through the woods during a school field trip. Upon returning home, she hugs her father, and he later develops poison ivy. Which of the following immune reactions is he experiencing?

• A. IgE-mediated
• B. Tissue-specific
• C. Immune complex
• D. Cell-mediated

Correct answer: D

Rationale: The father's immune reaction to poison ivy is an example of cell-mediated immunity, specifically a type IV hypersensitivity reaction. In this type of reaction, sensitized T cells react to antigens, leading to inflammation and tissue damage. IgE-mediated reactions involve antibodies of the IgE class, commonly seen in allergic responses like anaphylaxis. Tissue-specific reactions target specific organs or tissues. Immune complex reactions involve immune complexes formed by antigens and antibodies that can deposit in tissues, leading to inflammation.

3. When treating a patient for a fungal infection with IV amphotericin B, what should the nurse consistently monitor the patient's levels of to prevent drug discomfort?

• A. sodium
• B. hemoglobin
• C. calcium
• D. leukocytes

Correct answer: C

Rationale: When a patient is being treated with IV amphotericin B for a fungal infection, it is crucial to monitor the patient's calcium levels consistently. IV amphotericin B can cause hypokalemia, hypomagnesemia, and most notably, hypocalcemia. Monitoring calcium levels helps prevent drug-related discomfort and adverse effects. Sodium (Choice A), hemoglobin (Choice B), and leukocytes (Choice D) are not the primary parameters to monitor specifically for drug discomfort related to amphotericin B. Therefore, they are incorrect choices.

4. A patient is found to have liver disease, resulting in the removal of a lobe of his liver. Adaptation to the reduced size of the liver leads to ___________ of the remaining liver cells.

• A. Metaplasia
• B. Organ atrophy
• C. Compensatory hyperplasia
• D. Physiologic hyperplasia

Correct answer: C

Rationale: Compensatory hyperplasia is the process by which the remaining cells increase in number to adapt to the reduced size of the liver. In this case, after the removal of a lobe of the liver, the remaining cells undergo compensatory hyperplasia to compensate for the lost tissue. Metaplasia refers to the reversible change of one cell type to another, not an increase in cell number. Organ atrophy is the decrease in organ size due to cell shrinkage or loss, which is opposite to an increase in cell number seen in compensatory hyperplasia. Physiologic hyperplasia is the increase in cell number in response to a normal physiological demand, not specifically due to the removal of a portion of the organ.

5. A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in ______ is the most likely cause.

• A. Ferritin
• B. Gastric enzymes
• C. Intrinsic factor
• D. Erythropoietin

Correct answer: C

Rationale: Pernicious anemia is primarily caused by a decrease in intrinsic factor. Intrinsic factor is a protein produced by the stomach that is necessary for the absorption of vitamin B12 in the intestines. Without intrinsic factor, vitamin B12 cannot be absorbed properly, leading to anemia. Ferritin is a protein that stores iron in the body and is not directly related to pernicious anemia. Gastric enzymes play a role in digestion but are not the primary cause of pernicious anemia. Erythropoietin is a hormone produced by the kidneys to stimulate red blood cell production and is not linked to pernicious anemia.

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