Nursing Elites

1. A patient is being treated for active tuberculosis with ethambutol (Myambutol). The patient states to the nurse that he cannot identify the red and green on the traffic lights when he is driving. Based on this finding, what medical intervention is most appropriate?

• A. Assess for photosensitivity.
• B. Discontinue ethambutol (Myambutol).
• C. Decrease the ethambutol (Myambutol) dose.
• D. Administer vitamin B.

Correct answer: A

Rationale: The correct answer is to assess for photosensitivity. Ethambutol can cause optic neuritis, leading to visual disturbances, including difficulty differentiating red and green colors. This is a sign of optic nerve damage and requires immediate evaluation. Discontinuing ethambutol may be necessary if optic neuritis is confirmed, but this decision should be made by a healthcare provider. Decreasing the dose of ethambutol may not address the visual changes. Administering vitamin B does not directly address the side effect caused by ethambutol.

2. A client with a history of hypertension presents with a severe headache and blurred vision. What is the nurse's priority action?

• A. Administer pain relief medication.
• B. Obtain a stat head CT scan.
• C. Administer antihypertensive medications as prescribed.
• D. Call the healthcare provider immediately.

Correct answer: C

Rationale: The correct answer is to administer antihypertensive medications as prescribed. In a client with a history of hypertension presenting with severe headache and blurred vision, these symptoms could indicate a hypertensive crisis. The priority action is to lower the blood pressure promptly to prevent complications such as stroke, heart attack, or organ damage. Administering antihypertensive medications is crucial in this situation. Administering pain relief medication (Choice A) may temporarily alleviate symptoms but does not address the underlying issue of elevated blood pressure. Obtaining a stat head CT scan (Choice B) may be necessary to rule out other causes but should not delay the administration of antihypertensive medications. Calling the healthcare provider immediately (Choice D) is important but may not address the immediate need to lower blood pressure in a hypertensive crisis.

3. A patient has been prescribed conjugated estrogens for the treatment of menopausal symptoms. What should the nurse include in the patient teaching?

• A. Increase the intake of calcium-rich foods.
• B. Decrease the intake of high-fat foods.
• C. Avoid the use of tobacco.
• D. Avoid exposure to sunlight.

Correct answer: A

Rationale: The correct answer is A: Increase the intake of calcium-rich foods. Patients taking conjugated estrogens should increase their intake of calcium-rich foods to help prevent osteoporosis. Estrogen therapy can lead to an increased risk of osteoporosis, so ensuring an adequate intake of calcium is crucial. Choices B, decreasing high-fat foods, and C, avoiding tobacco, are general health recommendations but not directly related to the prescription of conjugated estrogens. Choice D, avoiding exposure to sunlight, is not a direct concern when taking conjugated estrogens.

4. Which immunoglobulin presents the first challenge to the antigen?

• A. IgA
• B. IgG
• C. IgM
• D. IgE

Correct answer: C

Rationale: IgM is the first immunoglobulin to challenge the antigen during an immune response. IgM is the primary antibody produced during the initial or primary immune response. It is efficient in agglutination and complement activation, making it crucial in the early stages of defense. IgA is mainly found in mucosal areas and secretions. IgG is the most abundant antibody in circulation and is involved in secondary immune responses. IgE is primarily associated with allergic reactions and parasitic infections. Therefore, IgM is the correct choice as it acts first during the immune response, while the other immunoglobulins have different roles and functions.

5. Which of the following would the nurse see in a client with thrombocytopenia?

• A. A decreased platelet cell count
• B. Decreased white blood cell count
• C. Increased red blood cell count
• D. An increased platelet cell count

Correct answer: A

Rationale: Thrombocytopenia is characterized by a decreased platelet cell count, leading to an increased risk of bleeding. Therefore, the correct answer is A. Choice B, a decreased white blood cell count, is not typically associated with thrombocytopenia. Choice C, an increased red blood cell count, is not a characteristic finding in thrombocytopenia. Choice D, an increased platelet cell count, is the opposite of what is observed in thrombocytopenia.

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