Nursing Elites

1. In nephritic syndrome compared to nephrotic syndrome, there is:

• A. higher amounts of albuminuria.
• B. negligible hematuria or absence of hematuria.
• C. presence of red blood cell casts in the urine.
• D. hypoalbuminemia

Correct answer: C

Rationale: In nephritic syndrome, the presence of red blood cell casts in the urine is a characteristic finding, reflecting glomerular inflammation and damage. This differentiates it from nephrotic syndrome, where red blood cell casts are typically absent. Choice A is incorrect because nephritic syndrome usually presents with less albuminuria compared to nephrotic syndrome. Choice B is incorrect as hematuria is a common feature of nephritic syndrome. Choice D is incorrect as hypoalbuminemia is more commonly associated with nephrotic syndrome.

2. What are the signs of thyroid crisis resulting from Graves' disease?

• A. Constipation with gastric distension.
• B. Bradycardia and bradypnea.
• C. Hyperthermia and tachycardia.
• D. Constipation and lethargy.

Correct answer: C

Rationale: In a thyroid crisis resulting from Graves' disease, the patient typically experiences symptoms such as hyperthermia (elevated body temperature) and tachycardia (rapid heart rate). These symptoms are indicative of the hypermetabolic state seen in thyroid storm. Choices A and D are incorrect as constipation and lethargy are not typical signs of a thyroid crisis; instead, patients with hyperthyroidism often experience diarrhea and agitation. Choice B is incorrect because bradycardia (slow heart rate) and bradypnea (slow breathing rate) are more commonly associated with hypothyroidism rather than a thyroid crisis in Graves' disease.

3. A tension pneumothorax requires a needle thoracostomy and/or chest tube placement as treatment to which component of the pathophysiology of the condition?

• A. An accumulation of blood in the pleural space, which makes it difficult for the lungs to exchange gases.
• B. Extreme pain caused by a fractured rib
• C. A large accumulation of trapped air in the pleural space affecting both the lungs and heart.
• D. Sudden failure of the respiratory system due to fluid accumulation in the alveoli

Correct answer: C

Rationale: A tension pneumothorax is characterized by a large accumulation of trapped air in the pleural space, creating pressure that affects both the lungs and heart. This condition can lead to life-threatening consequences by shifting mediastinal structures and impairing cardiac function. Treatment involves decompressing the trapped air to relieve the tension. Choices A, B, and D are incorrect as they do not describe the primary pathophysiological mechanism of tension pneumothorax, which is the accumulation of air in the pleural space, not blood, rib fractures, or alveolar fluid accumulation.

4. A 30-year-old woman presents with joint pain, a malar rash, and photosensitivity. Which of the following is the most likely diagnosis?

• A. Rheumatoid arthritis
• B. Systemic lupus erythematosus
• C. Psoriatic arthritis
• D. Dermatomyositis

Correct answer: B

Rationale: The correct answer is B: Systemic lupus erythematosus. Joint pain, a malar rash, and photosensitivity are classic symptoms of systemic lupus erythematosus. Choice A, Rheumatoid arthritis, is incorrect as it typically presents with symmetric joint involvement and morning stiffness. Psoriatic arthritis (Choice C) is characterized by joint pain associated with psoriasis, which is not described in the case. Dermatomyositis (Choice D) presents with muscle weakness, skin rash, and elevated muscle enzymes, different from the symptoms presented in the case.

5. A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:

• A. is normal with no sickle cell disease.
• B. is a sickle cell carrier.
• C. has sickle cell anemia.
• D. has thalassemia.

Correct answer: B

Rationale: The correct answer is that the person is a sickle cell carrier. In HbAS, 'Hb' stands for hemoglobin, 'A' indicates normal hemoglobin, and 'S' indicates the sickle cell trait. Individuals with HbAS are carriers of the sickle cell trait but do not have sickle cell disease. Choice A is incorrect because having the sickle cell trait means carrying the gene for sickle cell disease. Choice C is incorrect as sickle cell anemia is a different condition where individuals have two copies of the abnormal hemoglobin gene, resulting in the disease. Choice D is incorrect because thalassemia is a separate genetic disorder affecting the production of hemoglobin, not related to the sickle cell trait.

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