Nursing Elites

1. When evaluating the success of adding raltegravir to the drug regimen of a 42-year-old female patient with HIV, which laboratory value should the nurse prioritize?

• A. The patient's C-reactive protein levels
• B. The patient's erythrocyte sedimentation rate (ESR)
• C. The patient's viral load
• D. The patient's CD4 count

Correct answer: C

Rationale: The correct answer is C: The patient's viral load. In HIV management, monitoring the viral load is crucial to assess the effectiveness of antiretroviral therapy. A decrease in viral load indicates the treatment's success in controlling the HIV infection. Choices A, B, and D are less relevant in this context. C-reactive protein levels and erythrocyte sedimentation rate are markers of inflammation and non-specific indicators of infection, not specifically for HIV. CD4 count is important but not as immediate for evaluating the response to the newly added medication compared to monitoring the viral load.

2. The registered nurse is teaching a class on inflammation and explains that which cell is the predominant phagocyte arriving early at inflammatory and infection sites?

• A. Macrophages
• B. Mast cells
• C. Monocytes
• D. Neutrophils

Correct answer: D

Rationale: Neutrophils are the correct answer as they are the predominant phagocytes arriving early at inflammatory and infection sites. Neutrophils are part of the body's innate immune system and are among the first responders to sites of inflammation or infection. They play a crucial role in engulfing and destroying pathogens. Macrophages, although important phagocytes, usually arrive later at the site. Mast cells are involved in allergic reactions and not primarily phagocytes. Monocytes are precursors to macrophages and are not the predominant phagocytes arriving early at inflammatory sites.

3. What serious adverse effect should the nurse monitor for during testosterone therapy?

• A. Testosterone therapy increases the risk of cardiovascular events, so regular monitoring is essential.
• B. Testosterone therapy can cause liver dysfunction, so liver function tests should be monitored regularly.
• C. Testosterone therapy can lead to prostate cancer, so regular screenings are recommended.
• D. Testosterone therapy can lead to bone fractures, so bone density should be monitored.

Correct answer: A

Rationale: The correct answer is A. Testosterone therapy is associated with an increased risk of cardiovascular events. Therefore, the nurse should monitor the patient for cardiovascular complications. While monitoring liver function tests (choice B) and bone density (choice D) may be important in some cases, the primary concern during testosterone therapy is the risk of cardiovascular events. Prostate cancer screenings (choice C) are not directly related to testosterone therapy's adverse effects.

4. What best describes sepsis?

• A. An overwhelming allergic reaction
• B. Severe inflammatory response to a pathogen's endotoxins
• C. Unknown causes resulting in hypertension
• D. Poor nursing and health care provider interventions

Correct answer: B

Rationale: The correct answer is B. Sepsis is a severe inflammatory response to a pathogen's endotoxins, leading to widespread infection and organ dysfunction. Choice A is incorrect as sepsis is not primarily an allergic reaction. Choice C is incorrect as sepsis is not characterized by unknown causes resulting in hypertension. Choice D is incorrect as sepsis is a medical condition and not solely caused by poor nursing or healthcare provider interventions.

5. A patient has suffered from several infections in the last 6 months and unexplained impaired wound healing. What assessment should the nurse prioritize?

• A. Assess for pain.
• B. Assess for nutritional deficiencies.
• C. Assess genetic tendency for infection.
• D. Assess for edema and decreased hemoglobin.

Correct answer: B

Rationale: In this scenario, the patient's history of multiple infections and impaired wound healing indicates a potential issue with their immune system and overall health. Therefore, the nurse should prioritize assessing for nutritional deficiencies. Proper nutrition is essential for a healthy immune response and wound healing. Assessing for pain (choice A) may be important but addressing the root cause of the recurrent infections and impaired wound healing is crucial. Genetic tendency for infection (choice C) would be a less immediate concern compared to assessing for nutritional deficiencies. Edema and decreased hemoglobin (choice D) are not the most relevant assessments based on the patient's symptoms.

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