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Questions 1 - 10
1

A nurse administers one unit of packed red blood cells. 4-6 hours later, what change can be expected in the patient's hemoglobin levels?

3% increase

15% increase

5% decrease

20% increase

Explanation

A nurse should expect to see an approximately 3% increase in the recipient's hemoglobin 4-6 hours after the administration of one unit of packed red blood cells.

2

What nutrients are specifically needed for proper thyroid hormone production?

Tyrosine, iodine, and selenium

Methionine and magnesium

Iron, manganese, and biotin

Iodine and manganese

Explanation

The nutrients specifically required for thyroid hormone production are tyrosine, iodine, and selenium, in addition to zinc and several B vitamins. While magnesium, manganese, and methionine are all essential for metabolism and overall hormone production, they are not direct substrates or cofactors in the production of thyroid hormone.

3

A nurse administers one unit of packed red blood cells. 4-6 hours later, what change can be expected in the patient's hemoglobin levels?

3% increase

15% increase

5% decrease

20% increase

Explanation

A nurse should expect to see an approximately 3% increase in the recipient's hemoglobin 4-6 hours after the administration of one unit of packed red blood cells.

4

What enzyme, present in saliva, initiates the digestion of carbohydrates?

Amylase

Lipase

Pepsin

Protease

Explanation

The digestion of dietary carbohydrates is initiated by amylase, an enzyme present in saliva. This enzyme breaks down long carbohydrate molecules into shorter units such as disaccharides. Lipase breaks down fats and is not present in the saliva, rather it is secreted by the pancreas into the duodenum. Pepsin is a protease - an enzyme that breaks down proteins. This enzyme is secreted by the chief cells of the stomach in its zymogen form (pepsinogen). It is activated by the product of the parietal cells (hydrochloric acid). Note that amylase is also secreted by the pancreas to complete the chemical digestion of carbohydrates into monosaccharides so that they can be absorbed by the brush border of the small intestine.

5

Alice is a 25-year-old female who is visiting her primary care physician for a routine physical. Which of the following may be conducted at the appointment?

A papanicolaou test

A rapid antigen detection test

A urine analysis

A cervical cerclage

A vaginal ultrasound

Explanation

A papanicolaou test (pap smear) may be preformed routinely on adult women as a screening for cervical cancer. A rapid antigen detection test (rapid strep test), urine analysis, cervical cerclage, or vaginal ultrasound would not be part of routine screening.

6

A client calls the clinic and tells the nurse that her daughter has just been stung by a bee on the arm. She is worried that her daughter will have a severe reaction. What should the nurse do?

Tell the client to call back if the condition worsens

Ask the client if her daughter has ever been stung by a bee in the past

Instruct the client to keep the arm elevated until swelling goes away

Advise the client to bring her daughter to the emergency room

Explanation

The nurse does not have reason to suspect that the child will have an allergic reaction before symptoms are present. Thus, the patient should call back or come to the emergency room if symptoms present.

7

Eye lubricants are used for all but the following:

To achieve miosis during eye surgery

To replace tears or add moisture to eyes

To protect the eyes during surgery or diagnostic procedures

To moisten contact lenses or artificial eyes

Explanation

Eye lubricants are not used to achieve miosis during eye surgery. Eye lubricants are frequently used to treat dry eyes in cases where tears need to be replaced, to moisten contact lenses, or to protect eyes during surgery.

8

A patient reports to urgent care for colicky pain in the upper right quadrant that they rate as a seven out of ten. The night before they ate a fatty meal with two glasses of wine. Which of the following tests would help you asses for cholecystitis?

Murphy's sign

Mc Burney's point

Psoas sign

Rovsing's sign

Explanation

A positive Murphy's sign is an indication of cholecystitis, or gallbladder inflammation. Testing for Murphy's sign is performed during an abdominal exam by asking the patient to breathe out slowly while the fingers of the examiner are slid under the right costal margin and held in place with firm pressure. The patient is then asked to inhale, which forces the abdominal contents upward. Murphy's sign is considered positive if the patient winces or flinches when breathing in, due to pain when the inflamed gallbladder comes in contact with the examiner's fingertips.

Rovsing's sign, psoas sign, and McBurney's point are all tests for appendicitis.

9

Where does lipid digestion begin?

The duodenum

The ileum

The stomach

The jejunum

Explanation

While a small amount of fat digestion may occur in the mouth via the action of lingual lipase, the majority of lipid digestions begins in the duodenum. The presence of fat in the small intestine triggers release of pancreatic lipase, which enters the duodenum via the pancreatic duct. Fat digestion does not occur in the stomach.

10

What nutrients are specifically needed for proper thyroid hormone production?

Tyrosine, iodine, and selenium

Methionine and magnesium

Iron, manganese, and biotin

Iodine and manganese

Explanation

The nutrients specifically required for thyroid hormone production are tyrosine, iodine, and selenium, in addition to zinc and several B vitamins. While magnesium, manganese, and methionine are all essential for metabolism and overall hormone production, they are not direct substrates or cofactors in the production of thyroid hormone.

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