Nursing Elites

1. A 43-year-old man has tested positive for systemic candidiasis, and the care team has decided on IV fluconazole as a first-line treatment. When administering this medication, the nurse should

• A. administer the drug with lactated Ringer's.
• B. infuse the drug no faster than 200 mg/h.
• C. avoid administering the drug through a peripheral IV.
• D. administer prophylactic heparin prior to the fluconazole.

Correct answer: C

Rationale: When administering IV fluconazole, the nurse should avoid administering the drug through a peripheral IV. Fluconazole is known to cause phlebitis and tissue irritation if infused through a peripheral IV line. It is recommended to administer fluconazole through a central venous catheter to reduce the risk of complications. Choices A, B, and D are incorrect as there is no specific recommendation to administer the drug with lactated Ringer's, infuse it at a particular rate, or administer prophylactic heparin prior to fluconazole in this scenario.

2. When educating a client about to undergo a pacemaker insertion, the nurse explains the normal phases of cardiac muscle tissue. During the repolarization phase, the nurse will stress that membranes must be repolarized before they can be re-excited. Within the cell, the nurse understands that:

• A. Potassium channels open while sodium channels close, causing repolarization to the resting state.
• B. The influx of calcium is the primary stimulus for the repolarization of cardiac tissue.
• C. Only the electrical activity within the heart will determine when repolarization occurs.
• D. The cell membranes need to stay calm, resulting in muscle tissue becoming refractory.

Correct answer: A

Rationale: During the repolarization phase of cardiac muscle tissue, potassium channels open while sodium channels close. This process is crucial for the cardiac muscle to return to its resting state after depolarization. Potassium moving out of the cell and sodium staying out helps reset the membrane potential and prepare the cell for the next depolarization phase. The influx of calcium is not the primary stimulus for repolarization in cardiac tissue; it is mainly involved in the depolarization phase. While electrical activity within the heart influences repolarization, the specific ion movements described in choice A are what physiologically drive repolarization. Cell membranes need to be in an active state during repolarization, not calm, to facilitate the necessary ion movements for muscle tissue to properly function.

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. During the cellular stage of acute inflammation, which type of cells arrive first and in great numbers?

• A. Basophils
• B. Lymphocytes
• C. Neutrophils
• D. Platelets

Correct answer: C

Rationale: During the cellular stage of acute inflammation, neutrophils are the first responders. Neutrophils arrive at the site of injury in large numbers to combat pathogens and remove debris. Basophils and lymphocytes are also involved in the inflammatory response, but they are not the first to arrive. Platelets play a role in hemostasis and blood clotting, rather than being the primary cells involved in the initial inflammatory response.

5. What typically causes contact dermatitis?

• A. Fungal infection
• B. Long-term disorder from gout
• C. Contact with a skin allergen
• D. Staphylococcal infection

Correct answer: C

Rationale: Contact dermatitis is typically caused by contact with a skin allergen that triggers an allergic reaction. Choice A, fungal infection, is incorrect as contact dermatitis is not caused by fungi. Choice B, long-term disorder from gout, is also incorrect as gout is not typically associated with contact dermatitis. Choice D, Staphylococcal infection, is incorrect as contact dermatitis is primarily an allergic reaction rather than a bacterial infection.

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