Nursing Elites

1. A nurse practitioner is seeing a client in the clinic with a suspected diagnosis of bacterial meningitis. What should the nurse anticipate as the priority action?

• A. Administer the first dose of antibiotics immediately after blood cultures are drawn.
• B. Start an IV line and administer corticosteroids to reduce inflammation.
• C. Isolate the client to prevent the spread of infection.
• D. Perform a lumbar puncture to confirm the diagnosis.

Correct answer: A

Rationale: The correct answer is to administer the first dose of antibiotics immediately after blood cultures are drawn for suspected bacterial meningitis. This is crucial to initiate treatment promptly and improve patient outcomes. Starting an IV line and administering corticosteroids (Choice B) may be part of the treatment plan but administering antibiotics is the priority. Isolating the client (Choice C) is important to prevent the spread of infection but not the priority over initiating antibiotic therapy. Performing a lumbar puncture (Choice D) may confirm the diagnosis, but treatment should not be delayed for this step in suspected cases of bacterial meningitis.

2. A patient is prescribed sildenafil (Viagra) for erectile dysfunction. What condition would contraindicate the use of this medication?

• A. History of peptic ulcer disease
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of hypertension

Correct answer: B

Rationale: The correct answer is B: Use of nitrates. Sildenafil (Viagra) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates combined with sildenafil can lead to a dangerous drop in blood pressure. Choices A, C, and D are incorrect because a history of peptic ulcer disease, use of antihypertensive medications, or a history of hypertension are not direct contraindications for sildenafil use.

3. A nurse on a postsurgical unit is providing care for a 76-year-old female client who is two days post-hemiarthroplasty (hip replacement) and who states that her pain has been out of control for the last several hours, though she is not exhibiting signs of pain. Which guideline should the nurse use for short-term and long-term treatment of the client's pain?

• A. Pain is what the client says it is, even if she is not exhibiting outward signs.
• B. Pain should be treated only when it is associated with observable symptoms.
• C. Long-term opioid use is generally safe for elderly clients in a hospital setting.
• D. The client's pain should be reassessed after every dose of pain medication.

Correct answer: A

Rationale: Pain is a subjective experience, and the client's report of pain should be taken seriously even if there are no outward signs. Choice B is incorrect because pain can be present without observable symptoms, and waiting for observable signs may delay appropriate pain management. Choice C is incorrect because the safety of long-term opioid use in elderly clients is a complex issue and should be carefully evaluated due to the risk of adverse effects. Choice D is incorrect because while pain reassessment is important, it should not be limited to just after medication administration but should occur regularly to ensure adequate pain control.

4. What common symptom should be assessed in individuals with immunodeficiency?

• A. Anemia
• B. Recurrent infections
• C. Hypersensitivity
• D. Autoantibody production

Correct answer: B

Rationale: Recurrent infections are a hallmark symptom of immunodeficiency. Individuals with impaired immune systems are more susceptible to recurrent infections due to their compromised ability to fight off pathogens. Anemia (Choice A) is not a direct symptom of immunodeficiency but can be a consequence of chronic diseases. Hypersensitivity (Choice C) refers to exaggerated immune responses rather than impaired immune function. Autoantibody production (Choice D) is not typically a primary symptom of immunodeficiency but may be seen in certain autoimmune conditions.

5. What action is specific to hormonal contraceptives and should be taught to this woman?

• A. The cervical mucus is altered to prevent sperm penetration.
• B. The release of follicle-stimulating hormone is increased to block fertility.
• C. The maturation of the endometrial lining is activated by the contraceptive.
• D. The pituitary gland increases the synthesis and release of luteinizing hormone.

Correct answer: A

Rationale: The correct action specific to hormonal contraceptives that should be taught to the woman is that they alter cervical mucus to prevent sperm penetration. This mechanism helps in preventing pregnancy by reducing the chances of sperm reaching the egg. Choices B, C, and D are incorrect. Choice B is inaccurate as hormonal contraceptives work by inhibiting ovulation rather than increasing follicle-stimulating hormone release. Choice C is incorrect as hormonal contraceptives do not activate the maturation of the endometrial lining; instead, they modify it to prevent implantation. Choice D is also incorrect as hormonal contraceptives do not stimulate the pituitary gland to increase luteinizing hormone synthesis and release.

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