Nursing Elites

1. A patient is receiving epoetin alfa (Epogen) for anemia. Which of the following adjunctive therapies is imperative with epoetin alfa?

• A. Potassium supplements
• B. Sodium restriction
• C. Iron supplement
• D. Renal dialysis

Correct answer: C

Rationale: The correct answer is C: Iron supplement. When a patient is receiving epoetin alfa for anemia, it is imperative to provide iron supplementation as epoetin alfa works by stimulating the production of red blood cells, which require iron for hemoglobin synthesis. Therefore, iron supplementation is crucial to support the increased erythropoiesis. Choices A, B, and D are incorrect because potassium supplements, sodium restriction, and renal dialysis are not typically indicated as adjunctive therapies with epoetin alfa for anemia.

2. A 30-year-old male has been brought to the emergency department by his wife because of a severe headache, nausea, vomiting, and fever. A lumbar puncture is performed, and cerebrospinal fluid (CSF) analysis reveals a high protein count, low glucose, and numerous polymorphonuclear leukocytes (PMNs). Which organism is the most likely cause of these findings?

• A. Streptococcus pneumoniae
• B. Neisseria meningitidis
• C. Escherichia coli
• D. Listeria monocytogenes

Correct answer: A

Rationale: The cerebrospinal fluid (CSF) analysis findings of high protein count, low glucose, and numerous polymorphonuclear leukocytes (PMNs) are classic for bacterial meningitis. Among the choices, Streptococcus pneumoniae is the most likely cause in this case. Streptococcus pneumoniae is a common cause of bacterial meningitis in adults, especially presenting with symptoms such as severe headache, nausea, vomiting, and fever. Neisseria meningitidis is another common cause of bacterial meningitis but is more frequently associated with a different CSF profile. Escherichia coli is a common cause of neonatal meningitis, not typically seen in a 30-year-old male. Listeria monocytogenes is more commonly associated with meningitis in immunocompromised individuals and neonates, and typically presents differently in CSF analysis.

3. A nurse caring for a patient with a diagnosis of lung cancer is aware that the primary risk factor for developing lung cancer is:

• A. Alcohol consumption
• B. Smoking
• C. Poor diet
• D. Environmental exposure

Correct answer: B

Rationale: The correct answer is B: Smoking. Smoking is the primary risk factor for developing lung cancer. Tobacco smoke contains numerous carcinogens that can damage the cells in the lungs, leading to the development of cancer. Alcohol consumption (Choice A), poor diet (Choice C), and environmental exposure (Choice D) can contribute to overall health risks, but they are not the primary risk factors specifically associated with the development of lung cancer.

4. Which of the following is a sign of hypoglycemia?

• A. Rapid, deep breathing
• B. Increased urination
• C. Weakness and confusion
• D. High blood pressure

Correct answer: C

Rationale: The correct answer is C: Weakness and confusion. Hypoglycemia is characterized by low blood sugar levels, leading to inadequate glucose supply to the brain, resulting in symptoms like weakness and confusion. Choices A, B, and D are incorrect. Rapid, deep breathing is not typically a sign of hypoglycemia but can be seen in other conditions like respiratory issues. Increased urination is more commonly associated with conditions like diabetes mellitus, while high blood pressure is not a typical sign of hypoglycemia.

5. Nurse Sharie is assessing a parent who abused her child. Which of the following risk factors would the nurse expect to find in this case?

• A. Flexible role functioning between parents
• B. History of the parent having been abused as a child
• C. Single-parent home situation
• D. Presence of parental mental illness

Correct answer: B

Rationale: The correct answer is B: 'History of the parent having been abused as a child.' Research shows that a history of being abused as a child is a significant risk factor for child abuse. This cycle of abuse can sometimes continue from one generation to the next. Choices A, C, and D are incorrect. Flexible role functioning between parents, a single-parent home situation, and the presence of parental mental illness are important factors to consider in various contexts but may not specifically indicate a higher likelihood of child abuse in this case.

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