Nursing Elites

1. When assessing for potential signs and symptoms of cryptococcosis in a patient with HIV being treated with Amphotericin B, the nurse should prioritize what assessment?

• A. Neurological assessment
• B. Functional assessment
• C. Nutritional assessment
• D. Cardiac assessment

Correct answer: A

Rationale: In a patient with cryptococcosis and HIV, neurological assessment should be prioritized because cryptococcosis commonly affects the central nervous system, leading to symptoms such as headache, confusion, and altered mental status. This assessment is crucial in monitoring for any neurological complications and guiding appropriate interventions. Functional assessment focuses on the patient's ability to perform activities of daily living and is not directly associated with cryptococcosis. Nutritional assessment is important for overall health but is not the priority when assessing for cryptococcosis. Cardiac assessment is not a priority in cryptococcosis as the primary manifestations are related to the central nervous system.

2. What is a cause of the crystallization within the synovial fluid of the joint affected by gouty arthritis?

• A. Destruction of proteoglycans
• B. Underexcretion of uric acid
• C. Overexcretion of uric acid
• D. Increased absorption of uric acid

Correct answer: B

Rationale: The correct answer is B: Underexcretion of uric acid. Gouty arthritis is primarily caused by the underexcretion of uric acid, leading to its accumulation in joints and subsequent crystallization. Choices A, C, and D are incorrect as they do not directly relate to the pathophysiology of gout. Destruction of proteoglycans, overexcretion of uric acid, and increased absorption of uric acid are not primary causes of gouty arthritis.

3. A male patient is receiving androgen therapy for hypogonadism. What adverse effect should the nurse monitor for during this therapy?

• A. Increased risk of bone fractures
• B. Increased risk of cardiovascular events
• C. Increased risk of liver dysfunction
• D. Increased risk of prostate cancer

Correct answer: B

Rationale: The correct answer is B: Increased risk of cardiovascular events. Androgen therapy can lead to an increased risk of cardiovascular events like heart attacks and strokes, especially in older patients. Monitoring for signs and symptoms of cardiovascular issues is essential during this therapy. Choices A, C, and D are incorrect because androgen therapy is not typically associated with an increased risk of bone fractures, liver dysfunction, or prostate cancer.

4. What occurs in a client with polycythemia?

• A. Deficient plasma in the blood
• B. Increased lymphatic fluid being produced
• C. Increased red blood cells being produced
• D. Deficient number of red blood cells

Correct answer: C

Rationale: The correct answer is C: Increased red blood cells being produced. Polycythemia is a condition characterized by an elevated number of red blood cells in the blood. This increased concentration of red blood cells can lead to blood thickening and potentially result in complications such as blood clots. Choices A, B, and D are incorrect because polycythemia does not involve deficient plasma, increased lymphatic fluid production, or a deficient number of red blood cells.

5. A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is:

• A. live and can cause infection.
• B. mutated and infectious.
• C. inactive but still infectious.
• D. pathogenic.

Correct answer: A

Rationale: The correct answer is A: live and can cause infection. In patients like the one described with a history of heart transplant and receiving long-term steroids, who are immunocompromised, live attenuated vaccines are contraindicated. Live vaccines contain weakened (attenuated) forms of the virus or bacteria, which can replicate and cause mild infections in healthy individuals but can lead to serious infections in immunocompromised individuals. Choices B, C, and D are incorrect because attenuated vaccines are not mutated, not inactive, and not pathogenic in healthy individuals, respectively.

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