Nursing Elites

1. 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.

2. 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. Patients who are immunocompromised, like those receiving long-term steroids after an organ transplant, should not receive live vaccines because the live attenuated organisms in these vaccines can cause infections in individuals with weakened immune systems. Choice B is incorrect because attenuated vaccines are live but weakened, not mutated. Choice C is incorrect because while inactive, attenuated vaccines are not infectious. Choice D is incorrect because attenuated vaccines are not pathogenic; they are attenuated (weakened) forms of the pathogen.

3. How should rifampin most likely be administered to a patient diagnosed with tuberculosis?

• A. Orally, with food
• B. Orally, on an empty stomach
• C. Intramuscularly
• D. Intravenously, as a bolus

Correct answer: A

Rationale: Rifampin is typically administered orally, and it is recommended to be taken with food to enhance its absorption and reduce gastrointestinal side effects. Administering rifampin intramuscularly or intravenously is not the standard route of administration for this medication used in tuberculosis treatment.

4. A male patient with erectile dysfunction is prescribed sildenafil (Viagra). What specific instruction should the nurse provide to ensure the safe use of this medication?

• A. Take the medication with food to prevent nausea.
• B. Avoid taking nitrates while on this medication.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with milk to enhance absorption.

Correct answer: B

Rationale: The correct instruction the nurse should provide is to avoid taking nitrates while on sildenafil (Viagra). Combining sildenafil with nitrates can result in severe hypotension due to additive vasodilatory effects. Choice A is incorrect because sildenafil can be taken with or without food. Choice C is incorrect as there is no specific requirement to take sildenafil at bedtime. Choice D is incorrect as taking sildenafil with milk has not been shown to enhance its absorption.

5. A nurse is caring for a client with a newly inserted pacemaker. What is the most important nursing action post-procedure?

• A. Monitor the insertion site for signs of infection.
• B. Educate the client about activity restrictions.
• C. Monitor the client's heart rate and rhythm.
• D. Assess the client's lung sounds for signs of fluid overload.

Correct answer: A

Rationale: Post-procedure, monitoring the insertion site for signs of infection is crucial because it helps in early detection of any potential complications such as infection. While educating the client about activity restrictions, monitoring the client's heart rate and rhythm, and assessing lung sounds for signs of fluid overload are important aspects of care, the immediate priority post-procedure is to prevent infection at the insertion site, which could lead to serious complications.

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