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Atherosclerosis is a chronic inflammatory response of the vascular walls to endothelial injury. During the progression of these lesions, interaction occurs between various factors. Question: Which cells do NOT play a role in this process?
- A. Epithelial cells
- B. Lipoproteins
- C. Macrophages
- D. T-lymphocytes
Correct Answer: A
Rationale: Atherosclerosis macrophages, T-cells, lipoproteins clog, not epithelial outsiders. Nurses track this, a chronic vessel crew.
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Which organism is most commonly responsible for travelers diarrhea?
- A. toxigenic strain of e coli
- B. clostridium difficile
- C. salmonella
- D. rotavirus
Correct Answer: A
Rationale: Travelers' trots E. coli's toxigenic strain leads, not C. diff, salmonella, rotavirus, or cholera's flood. Nurses peg this chronic globe-trotter.
The nurse is arriving at the beginning of her shift and has taken report on four clients on a medical surgical unit. Which client should the nurse see first?
- A. A Client with pyelonephritis with nausea and vomiting
- B. A client with chronic obstructive pulmonary disease with an oxygen saturation of $90 \%$ on room air
- C. A client post vaginoplasty with bright red blood and clots in her catheter
- D. A client post-total abdominal hysterectomy with 9/10 pain
Correct Answer: C
Rationale: Bright red blood and clots post-vaginoplasty scream hemorrhage ABCs prioritize circulation, needing instant check for shock or transfusion. Pyelonephritis nags, COPD's stable at 90\%, pain's urgent but not bleeding. Nurses hit bleeding first, a life-line call in this post-op rush.
Melatonin is a hormone that is involved in the regulation of the circadian rhythm. Features of melatonin include:
- A. It circulates in the cerebrospinal fluid and blood.
- B. It has a plasma elimination half-life of 4 h.
- C. It is derived from tryptophan.
- D. It activates the pituitary adenylate cyclase mechanism of circadian wakefulness.
Correct Answer: A
Rationale: Melatonin, produced by the pineal gland, regulates sleep-wake cycles. It circulates in blood and cerebrospinal fluid, crossing the blood-brain barrier to signal darkness via the suprachiasmatic nucleus (SCN). Its half-life is short, about 30-60 minutes, not 4 hours, enabling rapid response to light cues. Synthesized from tryptophan via serotonin, it's a biochemical derivative responsive to environmental triggers. It acts on melatonin receptors (MT1, MT2) in the SCN, suppressing wakefulness-promoting adenylate cyclase, not activating pituitary mechanisms for wakefulness that's a misattribution. Its role dampens alertness, promoting sleep. Circulation in bodily fluids ensures systemic distribution, aligning circadian rhythms with night, making it foundational to sleep physiology and fatigue management.
You measure the abdominal circumference and the hip circumference of a male patient with hypertension, overweight and recently-diagnosed type 2 diabetes mellitus. Question: Which values are most likely to be found in this patient?
- A. Abdomen: 78 cm, hip: 78 cm
- B. Abdomen: 78 cm, hip: 86 cm
- C. Abdomen: 102 cm, hip: 90 cm
- D. Abdomen: 90 cm, hip: 102 cm
Correct Answer: C
Rationale: Type 2, hypertension, overweight belly bulges past hips, 102 cm to 90 cm fits metabolic syndrome's apple shape, not slim or reverse. Nurses measure this, a chronic girth clue.
In caring for a patient with neutropenia, what tasks can be delegated to the nursing assistant?
- A. Take vital signs every 4 hours
- B. Report temperature elevation >100.4°F
- C. Assess for sore throat, cough, or burning with urination
- D. Gather the supplies to prepare the room for protective isolation
Correct Answer: A
Rationale: Neutropenia heightens infection risk, requiring team vigilance. Taking vital signs every 4 hours fits nursing assistants' scope routine monitoring flags fevers, key in neutropenia, without needing assessment skills. Reporting fever >100.4°F is their duty once detected, but assessing symptoms like sore throat or cough demands RN judgment to interpret infection signs. Gathering supplies for isolation is assistive, not evaluative, suiting their role. Handwashing's universal, not a task to delegate. Vital signs delegation ensures timely data collection, freeing nurses to analyze and act, a practical split in caring for this vulnerable patient.