RN exams medical-surgical practice questions set 16

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The correct answer is B: Areolar connective tissue. In the image, region '2' appears loose and has fibroblasts, collagen fibers, and elastic fibers, typical of areolar connective tissue. Areolar tissue is a loose connective tissue that provides support and elasticity. Rationale: 1. Areolar connective tissue is characterized by loose arrangement of cells and fibers, providing support and elasticity. 2. Presence of fibroblasts, collagen fibers, and elastic fibers in region '2' matches the characteristics of areolar connective tissue. 3. Areolar tissue is commonly found beneath the epithelial layers and around blood vessels and organs, supporting the body and connecting different tissues. Summary: A: Reticular connective tissue is more densely packed with reticular fibers and is found in organs like the spleen and lymph nodes. C: Stratified squamous epithelium is a type of epithelial tissue, which is not seen in region '2'.

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Goosebumps occur when small muscles attached to hair follicles contract, causing hairs to stand upright and skin to pucker. These are the arrector pili muscles, smooth muscles in the dermis anchored to the hair follicle base and the epidermal-dermal junction. When stimulated by cold or emotion (via the sympathetic nervous system), they contract, pulling hairs erect, an evolutionary vestige from furrier ancestors to trap heat or signal threat. Sebaceous glands secrete sebum to lubricate hair and skin, not to cause goosebumps. 'Cappilary' (likely a typo for capillary) refers to blood vessels, which adjust for temperature but don't directly produce goosebumps. Collagen provides dermal strength but is a passive fiber, not a muscle. The arrector pili's action is involuntary, linked to thermoregulation and emotional response, and its distinct role in piloerection visible as goosebumps sets it apart as the key structure in this phenomenon.

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The correct answer is A because a patient with periorbital cellulitis requires close monitoring and immediate intervention due to the risk of complications such as vision loss or intracranial involvement. This assignment will provide the new graduate with an opportunity to develop critical thinking skills and prioritize care for a potentially unstable patient. Choice B is incorrect because a patient needing discharge instructions after skin grafts is usually stable and may not require acute interventions, making it less suitable for a new graduate. Choice C is incorrect because a dressing change for a stage 3 pressure ulcer post-hydrotherapy is a routine procedure that may not challenge the new graduate's critical thinking skills or require immediate interventions. Choice D is incorrect as teaching before a punch biopsy is important but not as time-sensitive or critical compared to managing a patient with periorbital cellulitis.

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T cell exhaustion is a state of T cell dysfunction that arises during chronic viral infections or cancer. In the case of a chronic viral infection, the persistent exposure to viral antigens leads to continuous stimulation of CD8+ cytotoxic T cells. Over time, this sustained stimulation can lead to T cell exhaustion, characterized by the upregulation of inhibitory receptors, impaired effector functions, and reduced proliferative capacity. As a result, despite the elevated levels of CD8+ T cells in the blood, their function may be compromised, ultimately impacting the immune response against the viral infection. In contrast, activation-induced cell death (AICD) may contribute to T cell loss during chronic infections but would not explain the persistently elevated CD8+ T cell levels. Thymic involution refers to the age-related decline in thymus function, which is not directly related to the observed increase in CD8+ T cells. Antigenic

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In a patient experiencing an acute asthma exacerbation with severe respiratory distress and hypoxemia, the most appropriate intervention is to initiate non-invasive positive pressure ventilation (NIPPV). NIPPV can help improve ventilation, decrease work of breathing, and correct hypoxemia by providing positive pressure to keep the airways open, reduce air trapping, and increase the elimination of carbon dioxide. This intervention can help improve oxygenation and reduce the need for invasive mechanical ventilation in patients with severe asthma exacerbations. Administering high-flow oxygen via nasal cannula alone may not provide enough support for patients with severe respiratory distress. Nebulized albuterol/ipratropium combination therapy and intravenous corticosteroid therapy are also important treatments for asthma exacerbations but are not the first-line interventions for patients with severe respiratory distress and hypoxemia.

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The correct answer is B: Acute pain related to central nervous system (CNS), gastrointestinal (GI), and flu-like effects. This is the most appropriate nursing diagnosis because immune suppressants commonly cause side effects like pain in the CNS, GI disturbances, and flu-like symptoms. The priority is to address the patient's immediate discomfort and provide appropriate pain management. Choice A (Anxiety related to diagnosis and drug therapy) may be a valid concern for the patient, but addressing acute pain is more urgent in this case. Choice C (Risk for infection related to immune stimulation) is incorrect because immune suppressants actually increase the risk of infection due to decreased immune response. Choice D (Imbalanced nutrition: More than body requirements) is not the most relevant nursing diagnosis for a patient receiving immune suppressants. Pain management takes precedence over addressing nutrition concerns.

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In the emergency department setting, the initial diagnostic test typically performed for a patient suspected of having a stroke is a noncontrast computed tomography (CT) scan of the head. This imaging study is crucial in evaluating and diagnosing stroke because it can quickly identify whether the person is having a hemorrhagic stroke (bleeding in the brain) or an ischemic stroke (blood clot blocking a blood vessel). The results of the CT scan help guide immediate treatment decisions, such as administering clot-busting medications for ischemic strokes or preparing for surgical interventions for hemorrhagic strokes. Carotid ultrasound studies and transcranial Doppler flow studies may be performed after the initial CT scan to further assess the extent of damage and the underlying cause of the stroke. The 12-lead electrocardiogram is useful in assessing the heart's electrical activity but is not the primary test for diagnosing stroke.

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Rationale for Correct Answer A: "Urethral injuries are associated with pelvic fractures" 1. Urethral injuries are commonly seen in patients with pelvic fractures due to the close anatomical proximity and the mechanism of injury. 2. Pelvic fractures can cause direct trauma to the urethra, leading to urethral injuries. 3. Urethral injuries may present with blood at the meatus, inability to void, or high-riding prostate on rectal examination. 4. Prompt diagnosis and management are crucial to prevent complications such as urinary retention or urethral stricture. Summary: - Choice B is incorrect as not all patients with microscopic hematuria require genitourinary evaluation. - Choice C is incorrect as gross hematuria and shock can be due to various causes, not solely major renal injuries. - Choice D is incorrect as some intraperitoneal bladder injuries may require surgical intervention, not just urinary catheter placement.

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The correct answer is B: Use a humidifier at night. Psoriasis is a chronic skin condition characterized by dry, flaky skin. Using a humidifier at night helps to add moisture to the air, preventing further drying of the skin and reducing irritation. This is crucial in managing psoriasis symptoms. Explanation of why other choices are incorrect: A: Liberally apply a lubricating cream three times daily - While moisturizing is important for managing psoriasis, applying a lubricating cream too frequently may not be necessary and could potentially irritate the skin further. C: Use an alcohol-based cleanser in the morning - Alcohol-based cleansers can be harsh on the skin and may exacerbate psoriasis symptoms by drying out the skin further. D: Take hot baths to reduce skin discomfort - Hot baths can actually worsen psoriasis symptoms by stripping the skin of its natural oils and moisture, leading to further dryness and irritation.

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Activating emergency medical services (EMS) for rapid transport to a stroke center is the most appropriate action for managing a conscious patient with a suspected stroke. Time is critical in stroke care, and receiving specialized treatment at a stroke center as soon as possible can significantly improve outcomes for stroke patients. EMS providers are trained to recognize the signs of stroke and can begin essential pre-hospital care measures while en route to the hospital. Administering aspirin immediately is not recommended without medical evaluation, as certain types of strokes (such as hemorrhagic strokes) can be worsened by aspirin. Placing the patient in a supine position may not be ideal, as maintaining an elevated position can help prevent aspiration in stroke patients. Encouraging the patient to eat and drink is not appropriate, as swallowing difficulties are common in stroke patients and can lead to aspiration pneumonia.