Nursing Elites

1. A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?

• A. Human immunodeficiency virus
• B. Drug-resistant tuberculosis
• C. Methicillin-resistant Staphylococcus aureus
• D. Vancomycin-resistant Staphylococcus aureus

Correct answer: B

Rationale: When a patient with active tuberculosis is not responding to antitubercular drug therapy, drug-resistant tuberculosis should be suspected. Drug-resistant tuberculosis occurs when the bacteria causing tuberculosis become resistant to the medications being used. Choices A, C, and D are incorrect because the scenario described does not align with HIV infection, methicillin-resistant Staphylococcus aureus, or vancomycin-resistant Staphylococcus aureus.

2. A 1-year-old child will receive her scheduled MMR vaccination shortly. The nurse should teach the child's parents that she may develop what possible adverse effect related to the administration of this vaccine?

• A. Cough and fever
• B. Pallor and listlessness
• C. Serum sickness
• D. Nausea and vomiting

Correct answer: A

Rationale: The correct answer is A: Cough and fever. After receiving the MMR vaccine, some children may experience mild adverse effects such as a low-grade fever and a mild cough. These symptoms are normal reactions to the vaccine and indicate that the child's immune system is responding appropriately. Choices B, C, and D are incorrect because pallor and listlessness, serum sickness, nausea, and vomiting are not common adverse effects associated with the MMR vaccine in children.

3. Where are most body fluids located?

• A. Intravascular space.
• B. Intracellular space.
• C. Extracellular space.
• D. Transcellular space.

Correct answer: B

Rationale: Most body fluids are located within cells in the intracellular space. While the extracellular space also contains body fluids, the majority is found within the cells. Intravascular space refers to fluids within blood vessels, and transcellular space includes fluids in compartments like cerebrospinal, pleural, and peritoneal cavities.

4. In the ED, a homeless client is brought in with severe hypothermia. The police officers also state that they found a 'bottle of booze' on the sidewalk next to him. This puts the nurse on high alert since alcohol contributes to hypothermia by:

• A. interfering with the appetite center in the brain, causing the person to not respond to hunger cues.
• B. causing the person to have less insulation from body fat.
• C. dulling mental awareness, impairing judgment to seek shelter.
• D. increasing the basal metabolic rate, leading to faster depletion of ATP.

Correct answer: C

Rationale: Alcohol impairs judgment and dulls mental awareness, making a person less likely to seek shelter when experiencing hypothermia. This impaired judgment can lead to risky behaviors that exacerbate the effects of cold exposure. Choice A is incorrect because alcohol does not directly interfere with the appetite center in the brain to the extent described. Choice B is incorrect as alcohol consumption does not directly impact the amount of body fat present. Choice D is incorrect because alcohol does not increase the basal metabolic rate but rather slows it down.

5. A patient is starting on a new oral contraceptive. What should the nurse emphasize about the timing of the medication?

• A. Take the medication at the same time each day to maintain stable hormone levels.
• B. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
• C. Oral contraceptives can be taken at any time of day as long as the schedule is consistent.
• D. Oral contraceptives are effective immediately upon starting, regardless of timing.

Correct answer: A

Rationale: The correct answer is A. It is crucial for patients taking oral contraceptives to take the medication at the same time each day to maintain stable hormone levels and ensure their effectiveness in preventing pregnancy. Choice B is incorrect because there is no specific requirement to take oral contraceptives in the morning. Choice C is incorrect because consistency in timing is essential, but it should be at the same time each day. Choice D is incorrect because oral contraceptives may take some time to reach peak effectiveness, so it is important to emphasize the need for consistent timing.

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