Nursing Elites

1. A female patient has been diagnosed with tuberculosis and begun multiple-drug therapy. The woman has asked the nurse why it is necessary for her to take several different drugs instead of one single drug. How should the nurse best respond to the patient's question?

• A. “Multiple drugs are used because doctors need to combat the TB bacteria from different angles to effectively treat the infection.”
• B. “The use of multiple drugs prevents the development of drug-resistant TB.”
• C. “Multiple drugs are prescribed because the final testing results for TB can take up to 3 weeks to confirm the most effective treatment.”
• D. “Multiple drugs are used in order to speed up the course of treatment.”

Correct answer: B

Rationale: The correct answer is B. Using multiple drugs in tuberculosis treatment helps prevent the development of drug-resistant TB. This approach is crucial because if the infection is not completely eradicated, the remaining bacteria may become resistant to the single drug used, making future treatments less effective. Choice A is incorrect because the use of multiple drugs is not due to uncertainty about which drug will work, but rather to address the bacteria from different angles. Choice C is incorrect as it misleads the patient about the reason for using multiple drugs. Choice D is also incorrect because the primary purpose of using multiple drugs is not to speed up treatment but to ensure effectiveness and prevent resistance.

2. When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the contraceptive's efficacy, potentially leading to decreased effectiveness. Therefore, patients should be advised to use additional contraception methods if they are also taking antibiotics. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is incorrect since taking oral contraceptives with food does not necessarily impact their effectiveness.

3. Which information would indicate more teaching is needed regarding hypersensitivity reactions? Type _______ hypersensitivity reactions involve an antibody response.

• A. I
• B. II
• C. III
• D. IV

Correct answer: D

Rationale: The correct answer is D: Type IV hypersensitivity reactions involve cell-mediated immunity, not an antibody response. This question tests knowledge of hypersensitivity reactions and their classification. Type I hypersensitivity reactions involve IgE antibodies, Type II involves IgG or IgM antibodies, and Type III involves immune complex deposition. Type IV hypersensitivity reactions are delayed and involve T cells, not antibodies. Therefore, if a person believes that Type IV hypersensitivity reactions involve an antibody response, more teaching is required.

4. A patient is receiving epoetin alfa (Epogen) for anemia. Which of the following adjunctive therapies is imperative with epoetin alfa?

• A. Potassium supplements
• B. Sodium restriction
• C. Iron supplement
• D. Renal dialysis

Correct answer: C

Rationale: The correct answer is C: Iron supplement. When a patient is receiving epoetin alfa for anemia, it is imperative to provide iron supplementation as epoetin alfa works by stimulating the production of red blood cells, which require iron for hemoglobin synthesis. Therefore, iron supplementation is crucial to support the increased erythropoiesis. Choices A, B, and D are incorrect because potassium supplements, sodium restriction, and renal dialysis are not typically indicated as adjunctive therapies with epoetin alfa for anemia.

5. After studying about viruses, which information indicates the student has a good understanding of viruses? Viruses:

• A. Contain no RNA or DNA
• B. Are capable of independent reproduction
• C. Replicate their genetic material inside host cells
• D. Are killed easily by antimicrobials

Correct answer: C

Rationale: The correct answer is C. Viruses replicate their genetic material inside host cells, which is a fundamental aspect of their life cycle. Choice A is incorrect because viruses contain either RNA or DNA. Choice B is incorrect as viruses cannot reproduce independently and rely on host cells for replication. Choice D is incorrect as viruses are not easily killed by antimicrobials due to their unique structure and mechanisms of infection.

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