Nursing Elites

1. How does influenza immunization produce immunity?

• A. The virus from the vaccine remains in the body until the end of the season
• B. An attenuated virus causes immune system suppression and triggers immunity
• C. The body identifies the virus and develops antibodies against the virus
• D. The vaccine remains in the injection site and produces immune cells

Correct answer: C

Rationale: The correct answer is C. Influenza immunization works by introducing a weakened or inactivated form of the virus into the body, allowing the immune system to recognize it as foreign. This recognition triggers the production of antibodies specific to the virus. Choice A is incorrect as the virus in the vaccine does not remain in the body until the end of the season. Choice B is incorrect as an attenuated virus does not cause immune system suppression but rather stimulates an immune response. Choice D is incorrect because the vaccine does not stay at the injection site but rather prompts a systemic immune response throughout the body.

2. A patient is being educated about sildenafil (Viagra). Which of the following statements by the patient indicates that further teaching is necessary?

• A. I can take this medication with nitroglycerin.
• B. This medication can cause an erection lasting more than 4 hours.
• C. I should not take this medication if I am taking medications containing nitrates.
• D. This medication is safe to take with any over-the-counter medication.

Correct answer: A

Rationale: The correct answer is A because sildenafil should not be taken with medications containing nitrates, such as nitroglycerin, due to the risk of severe hypotension. Choice B is incorrect because priapism (prolonged erection) is a serious side effect but does not require immediate intervention like severe hypotension. Choice C is incorrect as it correctly identifies a contraindication for sildenafil use. Choice D is incorrect because not all over-the-counter medications are safe to take with sildenafil, and interactions can occur.

3. A patient has been diagnosed with chronic renal failure. Which of the following agents will assist in raising the patient's hemoglobin levels?

• A. Epoetin alfa (Epogen, Procrit)
• B. Pentoxifylline (Pentoxil)
• C. Estazolam (ProSom)
• D. Dextromethorphan hydrobromide

Correct answer: A

Rationale: The correct answer is A: Epoetin alfa (Epogen, Procrit). Epoetin alfa is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in patients with chronic renal failure. By increasing red blood cell production, epoetin alfa helps raise hemoglobin levels in these patients. Pentoxifylline (Choice B) is not indicated for raising hemoglobin levels in chronic renal failure patients; it is a peripheral vasodilator used to improve blood flow. Estazolam (Choice C) is a benzodiazepine used for treating insomnia and has no role in raising hemoglobin levels. Dextromethorphan hydrobromide (Choice D) is a cough suppressant and is not used to raise hemoglobin levels in patients with chronic renal failure.

4. In the ED, a homeless client is brought in with severe hypothermia. The police officers also state that they found a 'bottle of booze' on the sidewalk next to him. This puts the nurse on high alert since alcohol contributes to hypothermia by:

• A. interfering with the appetite center in the brain, causing the person to not respond to hunger cues.
• B. causing the person to have less insulation from body fat.
• C. dulling mental awareness, impairing judgment to seek shelter.
• D. increasing the basal metabolic rate, leading to faster depletion of ATP.

Correct answer: C

Rationale: Alcohol impairs judgment and dulls mental awareness, making a person less likely to seek shelter when experiencing hypothermia. This impaired judgment can lead to risky behaviors that exacerbate the effects of cold exposure. Choice A is incorrect because alcohol does not directly interfere with the appetite center in the brain to the extent described. Choice B is incorrect as alcohol consumption does not directly impact the amount of body fat present. Choice D is incorrect because alcohol does not increase the basal metabolic rate but rather slows it down.

5. During a flu shot clinic, one of the questions the student nurse asks relates to whether the client has a history of Guillain-Barré syndrome. The client asks, 'What is that?' How should the nursing student reply?

• A. A type of paralysis that affects movement on both sides of the body. It may even involve the respiratory muscles.
• B. Swelling of your arm where you got your flu shot and maybe your eyes and lips had some swelling as well.
• C. A degenerative disease where you have trouble walking without the help of a cane or walker.
• D. Influenza-like illness where you had fever and chills for 2 to 3 days after your last flu shot.

Correct answer: A

Rationale: The correct answer is A because Guillain-Barré syndrome is an acute immune-mediated polyneuropathy that can lead to paralysis affecting movement on both sides of the body, and in severe cases, involving the respiratory muscles. Choice B is incorrect as it describes local swelling, not the systemic effects of Guillain-Barré syndrome. Choice C is incorrect as it describes a degenerative disease affecting mobility, not an acute immune-mediated condition like Guillain-Barré syndrome. Choice D is incorrect as it describes flu-like symptoms following a flu shot, which is not the same as Guillain-Barré syndrome.

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