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 56-year-old woman has been experiencing memory loss and confusion for the past year. The client is diagnosed with Alzheimer's disease. Which finding is most characteristic of this disease?

• A. Neurofibrillary tangles in the brain
• B. Demyelination of neurons in the brain
• C. Accumulation of beta-amyloid plaques
• D. Formation of Lewy bodies

Correct answer: C

Rationale: The correct answer is C: Accumulation of beta-amyloid plaques. Alzheimer's disease is characterized by the accumulation of beta-amyloid plaques in the brain. These plaques are formed from the buildup of beta-amyloid protein fragments between nerve cells. Choice A, neurofibrillary tangles, are a hallmark of another neurodegenerative disease called Alzheimer's disease. Choice B, demyelination of neurons, is more characteristic of diseases like multiple sclerosis. Choice D, formation of Lewy bodies, is associated with Lewy body dementia, not Alzheimer's disease.

3. Seizures are diagnosed by which of the following?

• A. Electroencephalogram (EEG) and ECG
• B. Seizure symptoms and complete blood count (CBC)
• C. Seizure symptoms and electrocardiogram (ECG)
• D. Seizure symptoms and EEG

Correct answer: D

Rationale: Seizures are most accurately diagnosed by EEG, which measures brain activity. Choice A is incorrect as ECG (electrocardiogram) measures heart activity, not brain activity. Choice B is incorrect as CBC (complete blood count) is a blood test and not used to diagnose seizures. Choice C is incorrect as an ECG (electrocardiogram) also measures heart activity, not brain activity, and is not the primary diagnostic tool for seizures.

4. A 43-year-old man has tested positive for systemic candidiasis, and the care team has decided on IV fluconazole as a first-line treatment. When administering this medication, the nurse should

• A. administer the drug with lactated Ringer's.
• B. infuse the drug no faster than 200 mg/h.
• C. avoid administering the drug through a peripheral IV.
• D. administer prophylactic heparin prior to the fluconazole.

Correct answer: C

Rationale: When administering IV fluconazole, the nurse should avoid administering the drug through a peripheral IV. Fluconazole is known to cause phlebitis and tissue irritation if infused through a peripheral IV line. It is recommended to administer fluconazole through a central venous catheter to reduce the risk of complications. Choices A, B, and D are incorrect as there is no specific recommendation to administer the drug with lactated Ringer's, infuse it at a particular rate, or administer prophylactic heparin prior to fluconazole in this scenario.

5. A woman is complaining that she feels like the room is spinning even though she is not moving. Which of the following is characteristic of benign positional vertigo?

• A. It usually occurs with a headache.
• B. Pupillary changes are common.
• C. It is usually triggered when the patient bends forward.
• D. Nystagmus continues even when the eyes fixate on an object.

Correct answer: C

Rationale: The correct answer is C: 'It is usually triggered when the patient bends forward.' Benign positional vertigo is often triggered by changes in head position, such as bending forward. Choices A, B, and D are incorrect. A is incorrect because benign positional vertigo is not typically associated with headaches. B is incorrect because pupillary changes are not a common feature of benign positional vertigo. D is incorrect because nystagmus in benign positional vertigo usually stops when the eyes fixate on an object.

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