Nursing Elites

1. Which information about a 60-year-old patient with MS indicates that the nurse should consult with the healthcare provider before giving the prescribed dose of dalfampridine (Ampyra)?

• A. The patient has relapsing-remitting MS
• B. The patient walks a mile a day for exercise
• C. The patient complains of pain with neck flexion
• D. The patient has an increased serum creatinine level

Correct answer: D

Rationale: The correct answer is that the patient has an increased serum creatinine level. Dalfampridine should not be given to patients with impaired renal function as it can worsen their condition. Options A, B, and C are unrelated to the administration of dalfampridine. The fact that the patient has relapsing-remitting MS, walks for exercise, or experiences neck pain does not directly impact the decision to administer dalfampridine. However, an increased serum creatinine level is a contraindication for this medication and requires consultation with the healthcare provider to determine the appropriate course of action.

2. Renal failure is broadly divided into specific categories. Which type is the type II diabetic patient most likely to experience secondary to diabetes?

• A. Acute renal failure (ARF)
• B. Intermittent renal failure (IRF)
• C. Chronic renal failure (CRF)
• D. Reversible renal failure (RRF)

Correct answer: C

Rationale: Diabetic nephropathy is a common complication in type II diabetic patients, leading to chronic renal failure (CRF). Chronic renal failure (CRF) and acute renal failure (ARF) are the two main categories of renal failure. CRF can result from various conditions including diabetic nephropathy, chronic glomerulonephritis, chronic pyelonephritis, polycystic kidney disease, connective tissue disorders, and amyloidosis. Unlike acute renal failure, chronic renal failure is irreversible. Timely treatment of ARF can often lead to reversibility, but CRF may require renal replacement therapy (RRT) or kidney transplant. Therefore, the correct answer is chronic renal failure (CRF). Intermittent renal failure (IRF) and reversible renal failure (RRF) are not recognized medical terms for distinct types of renal failure, making choices B and D incorrect.

3. The nurse is reviewing the characteristics of culture. Which statement is correct regarding the development of one's culture?

• A. Learned through language acquisition and socialization.
• B. Genetically determined on the basis of racial background.
• C. A nonspecific phenomenon and is adaptive but unnecessary.
• D. Biologically determined on the basis of physical characteristics.

Correct answer: A

Rationale: Culture is a complex phenomenon that includes attitudes, beliefs, self-definitions, norms, roles, and values learned from birth through the processes of language acquisition and socialization. It is not biologically or genetically determined, but rather acquired through social interactions. The correct answer, 'Learned through language acquisition and socialization,' aligns with the understanding that culture is a learned behavior. Choices B, C, and D are incorrect because culture is not genetically determined, nonspecific, or biologically based on physical characteristics. Understanding that culture is acquired through language and socialization is essential for healthcare providers to provide culturally competent care.

4. A 65-year-old man is prescribed Flomax (Tamsulosin) for Benign Prostatic Hyperplasia. The patient lives in an upstairs apartment. The nurse is most concerned about which side effect of Flomax?

• A. Hypotension
• B. Tachycardia
• C. Back Pain
• D. Difficulty Urinating

Correct answer: A

Rationale: The correct answer is 'Hypotension.' Flomax (Tamsulosin) is known to cause orthostatic hypotension, especially in the elderly, leading to a sudden drop in blood pressure when standing up. This side effect can result in dizziness, falls, and injury, especially concerning for a patient living in an upstairs apartment. Tachycardia (increased heart rate) and back pain are less commonly associated with Flomax use, while difficulty urinating is a symptom that Flomax is intended to improve in patients with Benign Prostatic Hyperplasia.

5. Which patient poses the least infection risk to an immunosuppressed patient who had a liver transplant?

• A. The patient with chronic pancreatitis
• B. The patient currently infected with a respiratory virus
• C. The patient with a healing leg wound
• D. The patient with a urinary tract infection

Correct answer: C

Rationale: The patient with a healing leg wound poses the least infection risk to an immunosuppressed patient who had a liver transplant. Chronic pancreatitis can lead to complications such as infections that can pose a risk to immunosuppressed individuals. Patients infected with respiratory viruses or urinary tract infections are actively infectious, which can put immunosuppressed patients at a higher risk of acquiring infections. Therefore, the patient with a healing leg wound is the least likely to pose an immediate infection risk.

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