Nursing Elites

1. A client needs to rapidly achieve a therapeutic plasma drug concentration of a medication. Rather than wait for steady state to be achieved, the physician might order:

• A. a maintenance dose.
• B. a loading dose.
• C. a medication with no first-pass effect.
• D. the medication to be given intravenously.

Correct answer: B

Rationale: To rapidly achieve a therapeutic plasma drug concentration, a loading or priming dose is ordered. This dose quickly establishes the desired drug level. It is calculated by multiplying the volume of distribution by the desired plasma drug concentration. A maintenance dose, like choice A, is used to maintain the therapeutic level after the loading dose. Waiting for steady state without a loading dose would take five drug half-lives. Choice C, a medication with no first-pass effect, does not directly address the need for rapid attainment of therapeutic levels. While intravenous administration (choice D) offers excellent bioavailability, a single dose by this route may not achieve the desired therapeutic plasma concentration as rapidly as a loading dose.

2. A 14-year-old boy has been admitted to a mental health unit for observation and treatment. The boy becomes agitated and starts yelling at nursing staff members. What should the nurse's first response be?

• A. Create an atmosphere of seclusion for the boy according to procedures.
• B. Remove other patients from the area for added safety.
• C. Ask the patient, "What is making you mad?"?
• D. Ask the patient, "Why are you behaving this way? Have you thought about what may help you calm down?"?

Correct answer: A

Rationale: In a situation where a patient is agitated and yelling, the first response should be to create an atmosphere of seclusion for the safety of the patient and others. Seclusion is a standard procedure to help manage aggressive behaviors and prevent harm. Options B, C, and D are not appropriate in this scenario. Removing other patients may not address the immediate safety concern, asking the patient what is making them mad can escalate the situation, and questioning why the patient is behaving that way may not help in managing the current agitation. Therefore, seclusion is the recommended course of action in this scenario to ensure the safety and well-being of all involved.

3. When teaching about preventable diseases, the importance of getting the following vaccines should be emphasized:

• A. human papillomavirus, genital herpes, measles.
• B. pneumonia, HIV, mumps.
• C. syphilis, gonorrhea, pneumonia.
• D. polio, pertussis, measles

Correct answer: D

Rationale: Vaccines are crucial in preventing communicable diseases. Smallpox has been eradicated globally, so its vaccine is no longer used. Polio, pertussis, and measles are diseases that are controlled by routine childhood immunization. While smallpox has been eradicated, these diseases still exist, making it essential for children to be vaccinated against them. Choices A, B, and C include diseases that are not prevented by vaccination or are not related to routine immunizations, making them incorrect choices.

4. The test used to differentiate sickle cell trait from sickle cell disease is:

• A. Sickle cell preparation.
• B. Peripheral smear.
• C. Sickledex.
• D. Hemoglobin electrophoresis

Correct answer: D

Rationale: The correct test to differentiate between sickle cell trait and sickle cell disease is hemoglobin electrophoresis. This test separates different types of hemoglobin based on their electrical charge, allowing for the identification of specific hemoglobin variants like HbS in sickle cell disease. Sickle cell preparation and Sickledex are not specific tests for this differentiation. While a peripheral smear can show sickle cells, it does not provide a definitive differentiation between the trait and the disease as it doesn't identify the specific hemoglobin variant present.

5. Nursing care for a client undergoing chemotherapy includes assessment for signs of bone marrow depression. Which finding accounts for some of the symptoms related to bone marrow depression?

• A. erythrocytosis
• B. leukocytosis
• C. polycythemia
• D. thrombocytopenia

Correct answer: D

Rationale: Thrombocytopenia is an abnormal decrease in the number of platelets, which results in bleeding tendencies. During chemotherapy, bone marrow depression can lead to a reduction in platelet production, causing thrombocytopenia. Erythrocytosis is an abnormal increase in red blood cells, leukocytosis is an increase in white blood cells, and polycythemia is an excess of red blood cells, which is synonymous with erythrocytosis. In the context of chemotherapy, the focus is on the decrease in red and white blood cells, making thrombocytopenia the most relevant finding.

Similar Questions