Nursing Elites

1. A patient is to be administered an immunization. The serum contains aluminum phosphate. What route is most appropriate to administer this immunization?

• A. Intramuscularly
• B. Subcutaneously
• C. Intravenously
• D. Orally

Correct answer: A

Rationale: The most appropriate route to administer an immunization containing aluminum phosphate is intramuscularly. Aluminum phosphate is commonly used as an adjuvant in vaccines to enhance the immune response. Intramuscular administration allows for the vaccine to be delivered into the muscle tissue, where it can be effectively absorbed by the body's immune cells. Subcutaneous administration is not ideal for vaccines containing aluminum phosphate, as it may not elicit the desired immune response. Intravenous administration is typically reserved for specific medications or situations that require rapid absorption into the bloodstream. Oral administration is not suitable for vaccines containing aluminum phosphate as they would be degraded in the gastrointestinal tract.

2. What is the purpose of the inflammatory response?

• A. Prevents blood from entering the injured tissue
• B. Elevates body temperature to prevent spread of infection
• C. Prevents formation of abscess
• D. Minimizes injury and promotes healing

Correct answer: D

Rationale: The inflammatory response is a protective mechanism triggered by tissue damage or infection. It aims to minimize injury by removing harmful stimuli and initiating the healing process. Choice A is incorrect because blood flow to the injured tissue is actually increased to deliver immune cells and nutrients. Choice B is incorrect because while fever is a response to infection, it is not the primary purpose of the inflammatory response. Choice C is incorrect because abscess formation can occur as part of the inflammatory response in an attempt to contain an infection.

3. A homeless man was screened for tuberculosis (TB) during a health consultation at a shelter, and the results indicate latent TB. The community health nurse who is liaising with the providers of the shelter would anticipate what component of this man's plan of care?

• A. The man will undergo conservative treatment for TB using adjuvant medications.
• B. The man will be treated for TB using first-line antitubercular drugs.
• C. The man will be monitored closely to determine if treatment is necessary.
• D. The man will be screened again in 10 to 12 weeks to determine if he has developed active TB.

Correct answer: B

Rationale: The correct answer is B. When a patient is diagnosed with latent TB infection, the standard approach involves treating them with first-line antitubercular drugs to prevent the progression to active TB. Adjuvant medications are not typically used for latent TB. Close monitoring without initiating treatment can lead to the development of active TB, so immediate treatment is crucial. Screening the individual again in 10 to 12 weeks does not address the immediate need for treatment of latent TB, which is essential to prevent the progression of the disease.

4. A college student has a TB test prior to starting the semester. The tuberculin test site is noted with a reddened, raised area. What condition will the student be diagnosed with if the chest radiograph is negative?

• A. Transmission
• B. Primary infection
• C. Latent tuberculosis
• D. Active tuberculosis

Correct answer: C

Rationale: If the chest radiograph is negative despite a positive tuberculin skin test, the student will be diagnosed with latent tuberculosis infection. Latent tuberculosis means the student has the TB bacteria in their body but does not feel sick and cannot spread the disease. Choice A, 'Transmission,' is incorrect as it refers to the spread of TB from person to person. Choice B, 'Primary infection,' is incorrect because primary infection occurs when a person is first infected with the TB bacteria. Choice D, 'Active tuberculosis,' is incorrect as this refers to the active form of the disease where the person feels sick and can spread TB to others.

5. Which individual is likely to have the best prognosis for recovery from his or her insult to the peripheral nervous system? An adult:

• A. client who developed rhabdomyolysis and ischemic injury after a tourniquet application.
• B. who suffered a bone-depth laceration to the shoulder during a knife attack.
• C. who had his forearm partially crushed by gears during an industrial accident.
• D. client who had nerves transected during surgery to remove a tumor from the mandible.

Correct answer: C

Rationale: The correct answer is C. Crushing-type injuries to the peripheral nervous system generally have a better prognosis compared to nerve transections or lacerations. In the scenario provided, the individual who had his forearm partially crushed by gears during an industrial accident is likely to have a better chance of recovery compared to nerve transection (choice D) or laceration (choice B). Rhabdomyolysis and ischemic injury after tourniquet application (choice A) are not directly related to peripheral nerve injury and do not indicate a better prognosis for recovery.

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