Nursing Elites

1. What is responsible for initiating clonal selection?

• A. B cells
• B. T cells
• C. Antigens
• D. Lymphocytes

Correct answer: C

Rationale: Antigens are the correct answer as they are the molecules that trigger the immune response by binding to specific B or T cells. This binding activates these cells, leading to their proliferation and differentiation to fight off the antigen. B cells and T cells are the responders to antigens, not the initiators of clonal selection. Lymphocytes is a broad term encompassing both B and T cells, so it is not the specific factor responsible for initiating clonal selection.

2. A patient is prescribed raloxifene (Evista) for osteoporosis. What is the primary mechanism of action for this medication?

• A. Raloxifene decreases bone resorption, which helps to maintain or increase bone density.
• B. Raloxifene increases calcium absorption in the intestines, which helps build stronger bones.
• C. Raloxifene stimulates new bone formation by increasing osteoblast activity.
• D. Raloxifene decreases calcium excretion by the kidneys, helping to maintain bone density.

Correct answer: A

Rationale: Raloxifene decreases bone resorption, which helps to maintain or increase bone density, making it effective in the prevention and treatment of osteoporosis.

3. After experiencing several months of worsening nocturia, a patient has been assessed for benign prostatic hypertrophy (BPH) and has begun drug treatment. In addition to nocturia, what other sign or symptom is most likely to accompany BPH?

• A. Hematuria
• B. Erectile dysfunction
• C. Urinary frequency
• D. Flank pain

Correct answer: A

Rationale: The correct answer is hematuria. Hematuria, which is the presence of blood in the urine, is a common sign associated with benign prostatic hypertrophy (BPH). It can occur due to irritation or damage to the prostate tissue. While urinary frequency and erectile dysfunction can also be seen in BPH patients, hematuria is more specifically linked to prostate issues. Flank pain is not typically a direct symptom of BPH.

4. A nurse is teaching a young adult patient about oral contraceptives, which the patient will soon begin taking. The patient's primary concern is the effectiveness of the medication in preventing pregnancy. The nurse should teach the patient that oral contraceptives, when taken consistently, are how effective in preventing pregnancy?

• A. Between 96% and 98%
• B. Approximately 98.5%
• C. Highly effective, but partially dependent on genetic factors
• D. Nearly 100%

Correct answer: D

Rationale: When taken correctly, estrogen–progestin contraceptive preparations are nearly 100% effective in preventing pregnancy. Choices A, B, and C are incorrect. Choice A suggests a range below the actual effectiveness, choice B provides a specific percentage that is not accurate, and choice C introduces the concept of genetic factors which is not relevant to the effectiveness of oral contraceptives.

5. A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

• A. Hyperactivity
• B. Spoon-shaped nails
• C. Gait problems
• D. Petechiae

Correct answer: B

Rationale: The correct answer is B: Spoon-shaped nails. In iron deficiency anemia, spoon-shaped nails (koilonychia) are a common symptom due to changes in the nail bed. This condition is known as Plummer-Vinson syndrome. While fatigue and weakness are common in iron deficiency anemia, hyperactivity (choice A) is not typically associated with this condition. Gait problems (choice C) and petechiae (choice D) are more commonly seen in other medical conditions and are not characteristic of iron deficiency anemia.

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