Nursing Elites

1. A 57-year-old male presents to his primary care provider with a red face, hands, feet, ears, headache, and drowsiness. A blood smear reveals an increased number of erythrocytes, indicating:

• A. Leukemia
• B. Sideroblastic anemia
• C. Hemosiderosis
• D. Polycythemia vera

Correct answer: D

Rationale: In this case, the symptoms of a red face, hands, feet, ears, headache, and drowsiness along with an increased number of erythrocytes in the blood smear are indicative of polycythemia vera. This condition is characterized by the overproduction of red blood cells, leading to symptoms related to increased blood volume and viscosity. Leukemia (Choice A) is a cancer of the blood and bone marrow, but the presentation described here is more suggestive of polycythemia vera. Sideroblastic anemia (Choice B) is characterized by abnormal iron deposits in erythroblasts, not an increased number of erythrocytes. Hemosiderosis (Choice C) refers to abnormal accumulation of iron in the body, not an increase in red blood cells as seen in polycythemia vera.

2. Which electrolyte imbalance does the nurse suspect in a patient with hyperaldosteronism?

• A. Hyponatremia
• B. Hypernatremia
• C. Hyperkalemia
• D. Hypercalcemia

Correct answer: C

Rationale: In a patient with hyperaldosteronism, the nurse would suspect hyperkalemia. Hyperaldosteronism leads to increased potassium excretion, resulting in low potassium levels in the blood. Therefore, choices A (Hyponatremia), B (Hypernatremia), and D (Hypercalcemia) are incorrect. Hyponatremia refers to low sodium levels, Hypernatremia refers to high sodium levels, and Hypercalcemia refers to high calcium levels, none of which are typically associated with hyperaldosteronism.

3. A patient being treated for tuberculosis is determined to be drug resistant. Which of the following medications will the patient be resistant to in the treatment of tuberculosis?

• A. Isoniazid (INH) and rifampin
• B. Carbamazepine (Tegretol) and phenytoin (Dilantin)
• C. Dextroamphetamine (Dexedrine) and doxapram (Dopram)
• D. Propranolol (Inderal) and sotalol (Betapace)

Correct answer: A

Rationale: In the treatment of tuberculosis, drug resistance commonly develops against medications like Isoniazid (INH) and rifampin. These two drugs are key components of the standard anti-tuberculosis treatment regimen. Choices B, C, and D are unrelated medications that are not used in the treatment of tuberculosis. Carbamazepine and phenytoin are anticonvulsants, dextroamphetamine is a stimulant, and propranolol and sotalol are used for cardiovascular conditions.

4. What type of immunity will the hepatitis B series provide a nursing student scheduled to receive it?

• A. Active immunity
• B. Passive immunity
• C. Innate immunity
• D. Natural immunity

Correct answer: A

Rationale: The correct answer is active immunity. The hepatitis B series immunization will provide active immunity, where the individual's immune system is stimulated to produce antibodies against the hepatitis B virus. This type of immunity is long-lasting and provides protection against future exposures. Passive immunity (choice B) involves the transfer of pre-formed antibodies and is temporary. Innate immunity (choice C) is the body's natural defense mechanisms, present at birth. Natural immunity (choice D) refers to immunity acquired through normal life processes, such as recovering from an infection.

5. A male patient receiving androgen therapy is concerned about the risk of prostate cancer. What should the nurse explain about this risk?

• A. Finasteride has been shown to lower the risk of developing prostate cancer.
• B. Finasteride does not affect the risk of prostate cancer, so regular screening is unnecessary.
• C. Finasteride may increase the risk of developing prostate cancer, so regular screenings are recommended.
• D. Finasteride has no effect on the risk of prostate cancer, so regular screenings are unnecessary.

Correct answer: A

Rationale: The correct answer is A. Finasteride has been shown to lower the risk of developing prostate cancer. However, regular screenings are still recommended to monitor for any potential issues. Choice B is incorrect because finasteride has been associated with a decreased risk of prostate cancer, making regular screenings important. Choice C is incorrect as finasteride is not known to increase the risk of developing prostate cancer. Choice D is incorrect as finasteride has shown a protective effect against prostate cancer, but regular screenings are still necessary to ensure early detection and monitoring.

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