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. During childhood, the thymus decreases in size, and this is referred to as ______ atrophy.

• A. Physiologic
• B. Pathologic
• C. Disuse
• D. Neurogenic

Correct answer: A

Rationale: The correct answer is A, 'Physiologic.' Physiologic atrophy is a normal part of development, like the reduction in thymus size during childhood. Pathologic atrophy (choice B) refers to tissue wasting due to disease, not a normal process like the reduction in thymus size. Disuse atrophy (choice C) results from a lack of physical activity or stimulation, which is not the case with thymus size reduction. Neurogenic atrophy (choice D) is caused by damage to or diseases of the nerves supplying the muscles, not related to the thymus size reduction seen in childhood.

3. Which of the following is a common cause of secondary hypertension?

• A. Primary aldosteronism
• B. Essential hypertension
• C. White coat hypertension
• D. Prehypertension

Correct answer: A

Rationale: Primary aldosteronism is a common cause of secondary hypertension. In primary aldosteronism, there is an overproduction of aldosterone from the adrenal glands, leading to increased sodium retention and potassium excretion, ultimately resulting in high blood pressure. Essential hypertension (Choice B) is the most common type of hypertension, but it is considered primary hypertension, not secondary. White coat hypertension (Choice C) refers to elevated blood pressure readings in a clinical setting due to anxiety but not in daily life. Prehypertension (Choice D) is a condition where blood pressure levels are elevated but not high enough to be classified as hypertension.

4. When starting on oral contraceptives, what should the nurse emphasize about the potential interactions with other medications?

• A. Oral contraceptives can be less effective when taken with certain antibiotics.
• B. Oral contraceptives are less effective when taken with food.
• C. Oral contraceptives are effective immediately after starting.
• D. Oral contraceptives have no interactions with other medications.

Correct answer: A

Rationale: The correct answer is A. Oral contraceptives can be less effective when taken with certain antibiotics, so patients should be informed about the potential need for additional contraception. Choice B is incorrect because taking oral contraceptives with food does not affect their effectiveness. Choice C is incorrect because oral contraceptives may take some time to become fully effective. Choice D is incorrect because oral contraceptives can interact with other medications, especially certain antibiotics, affecting their efficacy.

5. When does pain in the lower extremities due to peripheral artery disease usually worsen?

• A. with rest because blood flow decreases.
• B. with elevation of the extremity because blood is diverted away.
• C. when the leg is in a dependent position because blood pools.
• D. when the leg is touched or massaged because cytokines are released.

Correct answer: B

Rationale: Pain in the lower extremities due to peripheral artery disease usually worsens with elevation of the extremity because blood is diverted away from the affected area, leading to decreased perfusion and exacerbation of symptoms. Choices A, C, and D are incorrect because resting, dependent position, and touch/massage do not typically worsen the pain associated with peripheral artery disease.

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