Nursing Elites

1. A patient who was frequently homeless over the past several years has begun a drug regimen consisting solely of isoniazid (INH). What is this patient's most likely diagnosis?

• A. Active tuberculosis
• B. Latent tuberculosis
• C. Mycobacterium avium complex
• D. Human immunodeficiency virus

Correct answer: A

Rationale: The correct answer is A: Active tuberculosis. Given the patient's history of homelessness and initiation of isoniazid (INH) treatment, the most likely diagnosis is active tuberculosis. Isoniazid is a first-line medication used in the treatment of active tuberculosis. Latent tuberculosis (choice B) would not typically necessitate treatment with isoniazid alone. Mycobacterium avium complex (choice C) is not typically treated with isoniazid alone. Human immunodeficiency virus (choice D) is a risk factor for developing tuberculosis but is not the primary diagnosis in this patient scenario.

2. Identify which conditions are due to excessive immune response.

• A. Allergies and onychomycosis
• B. Type II diabetes and smallpox
• C. Chronic renal failure and macular degeneration
• D. Allergies and rheumatoid arthritis

Correct answer: D

Rationale: The correct answer is D: Allergies and rheumatoid arthritis. Allergies are caused by an excessive immune response to harmless substances, while rheumatoid arthritis is an autoimmune disorder where the immune system attacks the body's tissues, leading to inflammation and joint damage. Choices A, B, and C are incorrect. Onychomycosis is a fungal infection of the nails, Type II diabetes is a metabolic disorder not primarily related to immune response, smallpox is a viral infection, chronic renal failure is a kidney condition, and macular degeneration is an eye disorder, none of which are directly linked to excessive immune response.

3. A 45-year-old client is admitted with new-onset status epilepticus. What is the priority nursing intervention?

• A. Administer IV fluids and monitor electrolytes.
• B. Administer antiepileptic medications as prescribed.
• C. Ensure a patent airway and prepare for possible intubation.
• D. Monitor the client for signs of hypotension.

Correct answer: C

Rationale: The correct answer is C. In a client with new-onset status epilepticus, the priority nursing intervention is to ensure a patent airway and prepare for possible intubation. This is crucial to prevent hypoxia and further complications. Administering IV fluids and monitoring electrolytes (choice A) can be important but ensuring airway patency takes precedence. Administering antiepileptic medications (choice B) is essential but only after securing the airway. Monitoring for hypotension (choice D) is also important but not the priority when managing status epilepticus.

4. A patient is administered isoniazid (INH) for tuberculosis. Which of the following adverse effects will result in discontinuation of the medication?

• A. Weight gain
• B. Jaundice
• C. Fever
• D. Arthralgia

Correct answer: B

Rationale: The correct answer is B: Jaundice. Isoniazid (INH) is known to cause hepatotoxicity, which can manifest as jaundice. Jaundice is a serious adverse effect that warrants immediate discontinuation of the medication to prevent further liver damage. Weight gain, fever, and arthralgia are not typically associated with isoniazid use and would not necessitate discontinuation of the medication.

5. A patient's current medical condition is suggestive of impaired erythropoiesis. Which of the following laboratory studies would be most clinically relevant in diagnosing this health problem?

• A. White blood cell count with differential
• B. RBC, hemoglobin, and hematocrit
• C. INR and aPTT
• D. d-dimer and C-reactive protein

Correct answer: B

Rationale: In this scenario, where impaired erythropoiesis is suspected, the most clinically relevant laboratory studies would focus on red blood cell parameters. Therefore, assessing RBC count, hemoglobin levels, and hematocrit values would provide direct insights into erythropoiesis. Choices A, C, and D are not directly related to erythropoiesis assessment. White blood cell count with a differential is more indicative of immune response and infection. INR and aPTT are coagulation studies, while d-dimer and C-reactive protein levels are more associated with inflammation and thrombotic events.

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