Nursing Elites

1. What important point should the nurse emphasize about taking oral contraceptives consistently?

• A. Oral contraceptives must be taken at the same time each day to maintain consistent hormone levels and ensure effectiveness in preventing pregnancy.
• B. Oral contraceptives should be taken in the morning to avoid side effects at night.
• C. Oral contraceptives should be taken with food to enhance absorption.
• D. Oral contraceptives can be skipped occasionally without significant consequences.

Correct answer: A

Rationale: The correct answer is A. It is crucial for patients taking oral contraceptives to take them at the same time each day to maintain consistent hormone levels, which is essential for their effectiveness in preventing pregnancy. Choice B is incorrect as the timing of the medication is more about consistency than avoiding side effects at night. Choice C is incorrect as oral contraceptives do not necessarily need to be taken with food for absorption. Choice D is incorrect because skipping oral contraceptives occasionally can significantly reduce their effectiveness in preventing pregnancy.

2. 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.

3. When administering an immunization, which of the following medications should be available?

• A. Diphenhydramine (Benadryl)
• B. Hydroxyzine (Vistaril)
• C. Physostigmine
• D. Epinephrine

Correct answer: D

Rationale: When administering an immunization, it is essential to have epinephrine available in case of an allergic reaction such as anaphylaxis. Epinephrine is the medication of choice for treating severe allergic reactions due to its ability to reverse the symptoms rapidly. Diphenhydramine and hydroxyzine are antihistamines that can help manage mild allergic reactions but are not the primary medications for severe reactions like anaphylaxis. Physostigmine is not indicated for managing allergic reactions and is used for specific conditions such as anticholinergic toxicity.

4. A client with a history of chronic alcoholism presents to the emergency department with a complaint of double vision. Which cranial nerve is most likely involved?

• A. Cranial nerve I (Olfactory)
• B. Cranial nerve III (Oculomotor)
• C. Cranial nerve VI (Abducens)
• D. Cranial nerve VII (Facial)

Correct answer: C

Rationale: The correct answer is Cranial nerve VI (Abducens). Chronic alcoholism can lead to damage to the abducens nerve, which controls the lateral movement of the eye. This damage can result in symptoms like double vision. Cranial nerve I (Olfactory) is responsible for the sense of smell and is not related to eye movement. Cranial nerve III (Oculomotor) controls most of the eye movements but is less likely to be affected in chronic alcoholism than the abducens nerve. Cranial nerve VII (Facial) is responsible for facial movements and is not associated with double vision.

5. A patient who is undergoing treatment for cytomegalovirus received his first dose of IV ganciclovir 3 days ago. When reviewing this patient's most recent blood work, what abnormality should the nurse most likely attribute to the use of this drug?

• A. Hemoglobin 17 g/dL (high normal)
• B. INR 3.8 (high)
• C. Platelet count 118,000/mm3 (low)
• D. Leukocytes 11,900/mm3 (high)

Correct answer: C

Rationale: The correct answer is C: Platelet count 118,000/mm3 (low). Ganciclovir, used to treat cytomegalovirus, is known to cause bone marrow suppression, leading to decreased platelet count (thrombocytopenia). This condition can increase the risk of bleeding. Choices A, B, and D are not typically associated with ganciclovir therapy. High hemoglobin levels (choice A) are not commonly seen with ganciclovir treatment. INR elevation (choice B) is associated with coagulation abnormalities, which are not a typical side effect of ganciclovir. Elevated leukocyte count (choice D) is not a common consequence of ganciclovir use.

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