Nursing Elites

1. A client with chronic obstructive pulmonary disease (COPD) is admitted to the hospital for pneumonia. Which intervention should the nurse prioritize?

• A. Administer bronchodilators as prescribed.
• B. Monitor oxygen saturation levels continuously.
• C. Administer intravenous antibiotics as prescribed.
• D. Provide respiratory therapy treatments as needed.

Correct answer: C

Rationale: Administering IV antibiotics is crucial for treating pneumonia in a client with COPD. Pneumonia is an infection of the lungs that requires prompt antibiotic therapy to prevent complications and improve outcomes. While bronchodilators may help with COPD symptoms, in the case of pneumonia, addressing the infection is the priority. Continuous monitoring of oxygen saturation is important, but administering antibiotics to treat the underlying infection takes precedence. Respiratory therapy treatments can be beneficial, but they are not the initial priority when managing pneumonia in a client with COPD.

2. A patient is receiving chloroquine (Aralen) for extraintestinal amebiasis. Which of the following medications should be administered with chloroquine?

• A. Iodoquinol (Yodoxin)
• B. Metronidazole (Flagyl)
• C. Metyrosine (Demser)
• D. Carbamazepine (Tegretol)

Correct answer: B

Rationale: The correct answer is B: Metronidazole (Flagyl). When treating extraintestinal amebiasis, chloroquine is often used in combination with metronidazole to ensure the eradication of the parasite. Metronidazole helps to target the infection more effectively. Choices A, C, and D are incorrect. Iodoquinol (Yodoxin) is another antiprotozoal agent but is not typically used in combination with chloroquine for amebiasis. Metyrosine (Demser) is used in the management of pheochromocytoma, and carbamazepine (Tegretol) is an anticonvulsant and mood-stabilizing drug, neither of which are indicated for extraintestinal amebiasis.

3. A nurse is teaching a class about immune deficiencies, and a person from the audience asks which cells are affected by severe combined immune deficiency (SCID) syndrome, and the nurse answers:

• A. B cell deficits
• B. T cell deficits
• C. Complement deficits
• D. B and T cell deficits

Correct answer: D

Rationale: The correct answer is D: B and T cell deficits. Severe combined immune deficiency (SCID) syndrome affects both B and T cells, leading to a severe impairment in the immune system's ability to fight infections. Choice A (B cell deficits) is incorrect because SCID affects not only B cells but also T cells. Choice B (T cell deficits) is incorrect as SCID is characterized by deficits in both B and T cells. Choice C (Complement deficits) is incorrect as SCID primarily involves B and T cell deficiencies rather than complement deficiencies.

4. What long-term risks should the nurse discuss with a patient starting on hormone replacement therapy (HRT)?

• A. HRT is associated with increased risks of cardiovascular events and breast cancer, so these risks should be discussed with the patient.
• B. HRT can improve mood and energy levels, but it also increases the risk of osteoporosis.
• C. HRT can increase the risk of venous thromboembolism, so patients should undergo regular screening.
• D. HRT decreases the risk of fractures, but it also increases the risk of developing diabetes.

Correct answer: A

Rationale: The correct answer is A. When starting on hormone replacement therapy (HRT), the nurse should discuss the increased risks of cardiovascular events and breast cancer with the patient. These risks are important to consider to make an informed decision. Choice B is incorrect as HRT does not increase the risk of osteoporosis; in fact, it may help prevent it. Choice C is incorrect as while HRT can increase the risk of venous thromboembolism, regular screening is not the primary focus for discussion. Choice D is incorrect as HRT does not decrease the risk of fractures and is not primarily associated with an increased risk of developing diabetes.

5. Which of the following conditions is associated with a positive Homan's sign?

• A. Deep vein thrombosis
• B. Peripheral artery disease
• C. Varicose veins
• D. Lymphedema

Correct answer: A

Rationale: A positive Homan's sign is indicative of deep vein thrombosis. This sign is elicited by dorsiflexing the foot of a patient with the knee slightly flexed, resulting in calf pain. Peripheral artery disease (choice B) is associated with decreased blood flow to the extremities, but it does not produce a positive Homan's sign. Varicose veins (choice C) are enlarged, twisted veins that are typically not related to Homan's sign. Lymphedema (choice D) is swelling caused by a lymphatic system blockage or dysfunction and is not linked to Homan's sign.

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