Nursing Elites

1. A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is:

• A. live and can cause infection.
• B. mutated and infectious.
• C. inactive but still infectious
• D. pathogenic

Correct answer: A

Rationale: The correct answer is A: live and can cause infection. Patients who are immunocompromised, like those receiving long-term steroids after an organ transplant, should not receive live vaccines because the live attenuated organisms in these vaccines can cause infections in individuals with weakened immune systems. Choice B is incorrect because attenuated vaccines are live but weakened, not mutated. Choice C is incorrect because while inactive, attenuated vaccines are not infectious. Choice D is incorrect because attenuated vaccines are not pathogenic; they are attenuated (weakened) forms of the pathogen.

2. A 25-year-old just had a colonoscopy and was diagnosed with Crohn disease. Which of the following symptoms is consistent with this diagnosis?

• A. Right lower quadrant cramping
• B. Severe bloody diarrhea
• C. Nausea and vomiting
• D. Mostly affects the rectum

Correct answer: A

Rationale: The correct answer is A: Right lower quadrant cramping. Crohn's disease commonly presents with abdominal pain, particularly in the right lower quadrant. Choice B, severe bloody diarrhea, is more characteristic of ulcerative colitis, another type of inflammatory bowel disease. Choice C, nausea and vomiting, are not typical symptoms of Crohn's disease. Choice D is incorrect as Crohn's disease can affect any part of the gastrointestinal tract, not just the rectum.

3. What is the process of moving air into the lungs with subsequent distribution to the alveoli called?

• A. Ventilation
• B. Aeration
• C. Enclosure vapor
• D. Residual volume

Correct answer: A

Rationale: The correct answer is A: Ventilation. Ventilation is the process of moving air into the lungs and distributing it to the alveoli for gas exchange. Choice B, Aeration, is not the correct term for this specific process. Choice C, Enclosure vapor, is not related to the movement of air into the lungs. Choice D, Residual volume, refers to the amount of air left in the lungs after maximal expiration and is not the process of moving air into the lungs.

4. Which of the following would the nurse expect to see in a client experiencing hypoventilation?

• A. Increased oxygenation in the alveoli
• B. Increased carbon dioxide in the bloodstream
• C. Decreased hemoglobin in the bloodstream
• D. Decreased carbon dioxide in the alveoli

Correct answer: B

Rationale: In hypoventilation, there is inadequate ventilation leading to decreased removal of carbon dioxide. This results in increased carbon dioxide in the bloodstream. The other choices are incorrect because hypoventilation does not improve oxygenation in the alveoli (Choice A), decrease hemoglobin in the bloodstream (Choice C), or decrease carbon dioxide in the alveoli (Choice D).

5. Following the administration of her annual influenza vaccination, a health care worker remains at the clinic for observation due to pain at the injection site. What should the nurse recommend?

• A. ASA
• B. Acetaminophen
• C. Meperidine (Demerol)
• D. Heat application

Correct answer: B

Rationale: The correct recommendation for pain at the injection site after an influenza vaccination is Acetaminophen. Acetaminophen is a suitable choice for managing mild to moderate pain and fever commonly associated with vaccinations. Choice A, ASA (aspirin), is not recommended due to the risk of Reye's syndrome in children and teenagers following viral illnesses. Choice C, Meperidine (Demerol), is a potent opioid analgesic and is not typically indicated for mild pain relief. Choice D, heat application, is not the standard recommendation for pain at an injection site and may not provide adequate relief.

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