Nursing Elites

1. A person is given an attenuated antigen as a vaccine. When the person asks what was given in the vaccine, how should the nurse respond? The antigen is:

• A. Alive, but less infectious
• B. Mutated, but highly infectious
• C. Normal, but not infectious
• D. Inactive, but infectious

Correct answer: A

Rationale: An attenuated antigen used in a vaccine is alive but less infectious, aiming to stimulate an immune response. Choice B is incorrect because an attenuated antigen is not highly infectious. Choice C is incorrect as the antigen is intentionally altered to be less infectious. Choice D is incorrect as an attenuated antigen is not infectious.

2. A patient with hypogonadism is being treated with testosterone gel. What application instructions should the nurse provide?

• A. Apply the gel to the face and neck for maximum absorption.
• B. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• C. Apply the gel to the genitals for improved results.
• D. Apply the gel to the scalp and back.

Correct answer: B

Rationale: The correct answer is B. Testosterone gel should be applied to the chest or upper arms and allowed to dry completely before dressing to avoid transfer to others. Applying the gel to the face, neck, genitals, scalp, or back is not recommended as these areas may lead to unintentional transfer to others, inappropriate absorption, or potential side effects. Choice A is incorrect as applying the gel to the face and neck can lead to unwanted transfer. Choice C is incorrect as applying the gel to the genitals is not the recommended site for application. Choice D is incorrect as the scalp and back are not appropriate sites for applying testosterone gel.

3. What lab results would be noted in a client with leukocytosis?

• A. Increased white blood cell count
• B. Increased platelet count
• C. Decreased white blood cell count
• D. Decreased platelet count

Correct answer: A

Rationale: Leukocytosis is a condition characterized by an elevated white blood cell count, typically in response to infection or inflammation. Therefore, the correct answer is an increased white blood cell count (Choice A). Increased platelet count (Choice B) is not a typical finding in leukocytosis. Choices C and D, decreased white blood cell count and decreased platelet count respectively, are opposite to what would be expected in leukocytosis and are therefore incorrect.

4. A 55-year-old man presents with a history of fatigue, weight loss, and night sweats. He reports recent onset of a productive cough and hemoptysis. Which condition should the nurse suspect?

• A. Lung cancer
• B. Pneumonia
• C. Tuberculosis
• D. Pulmonary embolism

Correct answer: C

Rationale: The correct answer is C: Tuberculosis. The symptoms described - fatigue, weight loss, night sweats, productive cough, and hemoptysis - are classic manifestations of tuberculosis. Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, commonly affecting the lungs but can also involve other organs. **Choice A: Lung cancer** typically presents with symptoms like persistent cough, chest pain, and shortness of breath, but it is less likely in this case due to the presence of hemoptysis. **Choice B: Pneumonia** can present with productive cough, fever, and chest pain, but it is less likely given the chronicity of symptoms and the presence of hemoptysis. **Choice D: Pulmonary embolism** usually presents with sudden onset shortness of breath, chest pain, and can be associated with risk factors like recent surgery or immobility.

5. A patient taking oral contraceptives reports breakthrough bleeding. What should the nurse assess in this patient?

• A. Adherence to the medication schedule
• B. The possibility of pregnancy
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: A

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, the nurse should assess the patient's adherence to the medication schedule. Breakthrough bleeding can be a sign of missed doses or inconsistent timing, which can decrease the effectiveness of oral contraceptives. Assessing the patient's adherence helps in ensuring proper use of the medication. Choices B, C, and D are incorrect because breakthrough bleeding is more likely related to adherence issues rather than pregnancy, the need for increased dosage, or the effectiveness of the current oral contraceptive.

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