Nursing Elites

1. A patient is prescribed estradiol (Estrace) for hormone replacement therapy. What should the nurse monitor during this therapy?

• A. Blood pressure
• B. Blood glucose levels
• C. Liver function tests
• D. Kidney function tests

Correct answer: C

Rationale: During estradiol therapy, the nurse should monitor liver function tests. Estradiol can potentially impact liver function, making it essential to assess for any signs of liver dysfunction. Monitoring blood pressure (Choice A) is not directly related to estradiol therapy. While blood glucose levels (Choice B) should be monitored in patients taking certain medications like corticosteroids or antipsychotics, it is not typically necessary for patients on estradiol therapy. Kidney function tests (Choice D) are not the priority for monitoring during estradiol therapy, as the liver is more commonly affected.

2. A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:

• A. is normal with no sickle cell disease.
• B. is a sickle cell carrier.
• C. has sickle cell anemia.
• D. has thalassemia.

Correct answer: B

Rationale: The correct answer is that the person is a sickle cell carrier. In HbAS, 'Hb' stands for hemoglobin, 'A' indicates normal hemoglobin, and 'S' indicates the sickle cell trait. Individuals with HbAS are carriers of the sickle cell trait but do not have sickle cell disease. Choice A is incorrect because having the sickle cell trait means carrying the gene for sickle cell disease. Choice C is incorrect as sickle cell anemia is a different condition where individuals have two copies of the abnormal hemoglobin gene, resulting in the disease. Choice D is incorrect because thalassemia is a separate genetic disorder affecting the production of hemoglobin, not related to the sickle cell trait.

3. A patient has acute respiratory failure (ARF). Which of the following would the nurse expect to find?

• A. Alkalosis and hyperventilation
• B. Hypoxemia and hypercapnia
• C. Alkalosis and high potassium
• D. Elevated sodium and acidosis

Correct answer: B

Rationale: In acute respiratory failure, hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide) are commonly observed. Choice A is incorrect because alkalosis (high pH) and hyperventilation are not typically seen in acute respiratory failure. Choice C is incorrect as it mentions alkalosis and high potassium, which are not characteristic of acute respiratory failure. Choice D is also incorrect because elevated sodium and acidosis are not typically associated with acute respiratory failure.

4. A 34-year-old woman has presented to the clinic for the first time, and the nurse learns that she has been taking Depo Provera for the past 13 years. This aspect of the woman's medical history should prompt what assessment?

• A. Cardiac stress testing
• B. Renal ultrasound
• C. Bone density testing
• D. Evaluation of triglyceride levels

Correct answer: C

Rationale: The correct answer is bone density testing (Choice C). Long-term use of Depo Provera, a hormonal contraceptive, is associated with decreased bone mineral density. Assessing bone density is crucial to monitor for potential osteoporosis. Cardiac stress testing (Choice A) is not indicated based on the medication history provided. Renal ultrasound (Choice B) and evaluation of triglyceride levels (Choice D) are not directly related to the use of Depo Provera.

5. 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.

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