Nursing Elites

1. Which statement best conveys an aspect of the role of cerebrospinal fluid (CSF)?

• A. CSF provides immune protection to the brain and spinal cord by serving as a physical barrier.
• B. CSF cushions the brain and spinal cord, protecting them from injury.
• C. CSF plays a limited role in the exchange of nutrients and waste products between the blood and brain.
• D. CSF functions primarily as a medium for the transmission of nerve impulses.

Correct answer: B

Rationale: The correct answer is B. Cerebrospinal fluid primarily cushions the brain and spinal cord, protecting them from injury. Choice A is incorrect because while CSF contributes to the brain's immune environment, its main role is not providing immune protection as a physical barrier. Choice C is incorrect because CSF has a significant role in the exchange of nutrients and waste products, rather than a limited one. Choice D is incorrect as CSF is not primarily a medium for nerve impulse transmission, but rather serves as a protective and supportive fluid.

2. Interpret the following arterial blood gas results: PH = 7.30; PaCO2 = 55 mmHg; HCO3 = 24 mEq/L

• A. Respiratory acidosis
• B. Metabolic acidosis
• C. Respiratory alkalosis
• D. Metabolic alkalosis

Correct answer: A

Rationale: The correct answer is A: Respiratory acidosis. In respiratory acidosis, there is an accumulation of CO2 in the blood, leading to a decrease in pH. The elevated PaCO2 of 55 mmHg in the given results indicates hypoventilation, causing respiratory acidosis. Choices B, C, and D are incorrect because the provided data does not show metabolic acidosis, respiratory alkalosis, or metabolic alkalosis.

3. A 69-year-old female patient has been diagnosed with malignant melanoma. The care team has collaborated with the patient and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the patient may develop which of the following adverse effects?

• A. Profound diaphoresis
• B. Decreased level of consciousness
• C. Flu-like symptoms
• D. Cyanosis and pallor

Correct answer: C

Rationale: After the administration of interferon alfa-2b, the patient may develop flu-like symptoms as an adverse effect. Flu-like symptoms are commonly associated with interferon therapy, including fever, chills, fatigue, and muscle aches. These symptoms usually subside over time. Options A, B, and D are not typically associated with interferon alfa-2b administration. Profound diaphoresis is excessive sweating, decreased level of consciousness indicates neurological issues, and cyanosis and pallor suggest circulatory or respiratory problems, none of which are expected adverse effects of interferon alfa-2b.

4. Why does multiple sclerosis manifest as asymmetrical and in different parts of the body?

• A. Autoreactive lymphocytes are causing diffuse patchy damage to the myelin sheath in the central nervous system.
• B. Acetylcholine receptors are destroyed by immunoglobulin G.
• C. Autoreactive T lymphocytes cause progressive loss of neurons in the substantia nigra.
• D. Cortical motor cells degenerate.

Correct answer: C

Rationale: Multiple sclerosis is characterized by the immune system mistakenly attacking the myelin sheath in the central nervous system. This results in the formation of lesions that can occur in different parts of the central nervous system, leading to varied symptoms depending on the location of the damage. Choice A is the correct answer because it accurately describes the pathophysiology of multiple sclerosis. Choices B, C, and D are incorrect because they describe mechanisms or locations that are not associated with the pathogenesis of multiple sclerosis.

5. A patient has acute respiratory failure (ARF). Which of the following would the nurse expect to find?

• A. Alkalosis and hyperventilation
• B. Hypoxemia and hypercapnia
• C. Alkalosis and high potassium
• D. Elevated sodium and acidosis

Correct answer: B

Rationale: In acute respiratory failure, hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide) are commonly observed. Choice A is incorrect because alkalosis (high pH) and hyperventilation are not typically seen in acute respiratory failure. Choice C is incorrect as it mentions alkalosis and high potassium, which are not characteristic of acute respiratory failure. Choice D is also incorrect because elevated sodium and acidosis are not typically associated with acute respiratory failure.

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