Nursing Elites

1. A patient has suffered from several infections in the last 6 months and unexplained impaired wound healing. What assessment should the nurse prioritize?

• A. Assess for pain.
• B. Assess for nutritional deficiencies.
• C. Assess genetic tendency for infection.
• D. Assess for edema and decreased hemoglobin.

Correct answer: B

Rationale: In this scenario, the patient's history of multiple infections and impaired wound healing indicates a potential issue with their immune system and overall health. Therefore, the nurse should prioritize assessing for nutritional deficiencies. Proper nutrition is essential for a healthy immune response and wound healing. Assessing for pain (choice A) may be important but addressing the root cause of the recurrent infections and impaired wound healing is crucial. Genetic tendency for infection (choice C) would be a less immediate concern compared to assessing for nutritional deficiencies. Edema and decreased hemoglobin (choice D) are not the most relevant assessments based on the patient's symptoms.

2. An older adult patient has asked her primary care provider for a prescription that will help to resolve her “warped toenails.” The care provider has diagnosed the woman with onychomycosis. The nurse should anticipate that this patient will be treated with what drug?

• A. Micafungin (Mycamine)
• B. Terbinafine (Lamisil)
• C. Voriconazole (Vfend)
• D. Fluconazole (Diflucan)

Correct answer: B

Rationale: The correct answer is B: Terbinafine (Lamisil). Terbinafine is commonly used to treat onychomycosis, a fungal infection of the toenails or fingernails. It works by stopping the growth of the fungus. Micafungin (Mycamine) is an antifungal medication used for different types of fungal infections but is not typically used to treat onychomycosis. Voriconazole (Vfend) is another antifungal medication used for specific fungal infections, but it is not a first-line treatment for onychomycosis. Fluconazole (Diflucan) is also an antifungal medication, but it is more commonly used for yeast infections and may not be as effective for treating onychomycosis compared to terbinafine.

3. A patient is prescribed testosterone gel for hypogonadism. What important instruction should the nurse provide regarding the application of this medication?

• A. Apply the gel to the chest or upper arms.
• B. Apply the gel to the face and neck.
• C. Apply the gel to the genitals for maximum absorption.
• D. Apply the gel to the scalp and back.

Correct answer: A

Rationale: The correct answer is to apply the testosterone gel to the chest or upper arms. This is recommended to minimize the risk of unintentional transfer of the medication to others, especially women and children, through skin contact. Applying the gel to the face, neck, or genitals is not advised as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp or back is not appropriate as these areas are not indicated for absorption of testosterone.

4. The registered nurse is teaching a class on inflammation and explains that which cell is the predominant phagocyte arriving early at inflammatory and infection sites?

• A. Macrophages
• B. Mast cells
• C. Monocytes
• D. Neutrophils

Correct answer: D

Rationale: Neutrophils are the correct answer as they are the predominant phagocytes arriving early at inflammatory and infection sites. Neutrophils are part of the body's innate immune system and are among the first responders to sites of inflammation or infection. They play a crucial role in engulfing and destroying pathogens. Macrophages, although important phagocytes, usually arrive later at the site. Mast cells are involved in allergic reactions and not primarily phagocytes. Monocytes are precursors to macrophages and are not the predominant phagocytes arriving early at inflammatory sites.

5. What is the distinguishing feature of Hodgkin disease noted on histologic exam?

• A. Reed-Sternberg cells
• B. Red-stained cells
• C. Human Papillomavirus
• D. B-cells and T-cells

Correct answer: A

Rationale: The correct answer is A: Reed-Sternberg cells. Reed-Sternberg cells are large, abnormal B-cells that are characteristic of Hodgkin's lymphoma. These cells are identified on histologic examination of lymph node biopsies from patients with Hodgkin disease. Choice B, 'Red-stained cells,' is vague and does not describe a specific feature of Hodgkin disease. Choice C, 'Human Papillomavirus,' is incorrect as Hodgkin disease is not caused by HPV. Choice D, 'B-cells and T-cells,' is incorrect as Hodgkin disease is characterized by the presence of Reed-Sternberg cells, which are abnormal B-cells.

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