Nursing Elites

1. What is a characteristic of coronary artery disease (CAD)?

• A. The build-up of infectious by-products in the lymph nodes
• B. Insufficient delivery of oxygenated blood to the myocardium
• C. Insufficient delivery of carbon dioxide to the lungs
• D. The build-up of bile in the stomach and gallbladder

Correct answer: B

Rationale: The correct characteristic of coronary artery disease (CAD) is the insufficient delivery of oxygenated blood to the myocardium. CAD is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle. This lack of oxygenated blood can result in chest pain, known as angina, and if a coronary artery becomes completely blocked, it can cause a heart attack. Choices A, C, and D are incorrect. Choice A refers to an issue related to the lymphatic system, choice C is about gas exchange in the lungs, and choice D describes a problem with bile accumulation in the digestive system, none of which are characteristics of CAD.

2. A patient suffers from an autoimmune disorder. Which of the following represents a potential result of a viral infection in a patient with an autoimmune disorder?

• A. Lymphocytes recognize the host's tissue as foreign.
• B. Erythrocytes destroy the T cells of the host.
• C. The involution of the thymus gland increases the risk of infection.
• D. The differential decreases the sedimentation rate.

Correct answer: A

Rationale: In a patient with an autoimmune disorder, a viral infection can trigger an immune response where lymphocytes mistakenly recognize the host's tissue as foreign. This can lead to an exacerbation of the autoimmune condition. Choice B is incorrect because erythrocytes are not responsible for destroying T cells. Choice C is incorrect as thymus involution weakens the immune response, making the patient more susceptible to infections rather than increasing the infection risk. Choice D is unrelated to the potential effects of a viral infection in a patient with an autoimmune disorder.

3. A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?

• A. Oral contraceptives can cause weight loss and increased energy levels.
• B. Oral contraceptives can cause increased appetite and weight gain.
• C. Oral contraceptives can cause headaches and breast tenderness.
• D. Oral contraceptives have no side effects.

Correct answer: C

Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.

4. A patient who is undergoing treatment for cytomegalovirus received his first dose of IV ganciclovir 3 days ago. When reviewing this patient's most recent blood work, what abnormality should the nurse most likely attribute to the use of this drug?

• A. Hemoglobin 17 g/dL (high normal)
• B. INR 3.8 (high)
• C. Platelet count 118,000/mm3 (low)
• D. Leukocytes 11,900/mm3 (high)

Correct answer: C

Rationale: The correct answer is C: Platelet count 118,000/mm3 (low). Ganciclovir, used to treat cytomegalovirus, is known to cause bone marrow suppression, leading to decreased platelet count (thrombocytopenia). This condition can increase the risk of bleeding. Choices A, B, and D are not typically associated with ganciclovir therapy. High hemoglobin levels (choice A) are not commonly seen with ganciclovir treatment. INR elevation (choice B) is associated with coagulation abnormalities, which are not a typical side effect of ganciclovir. Elevated leukocyte count (choice D) is not a common consequence of ganciclovir use.

5. A 43-year-old man has tested positive for systemic candidiasis, and the care team has decided on IV fluconazole as a first-line treatment. When administering this medication, the nurse should

• A. administer the drug with lactated Ringer's.
• B. infuse the drug no faster than 200 mg/h.
• C. avoid administering the drug through a peripheral IV.
• D. administer prophylactic heparin prior to the fluconazole.

Correct answer: C

Rationale: When administering IV fluconazole, the nurse should avoid administering the drug through a peripheral IV. Fluconazole is known to cause phlebitis and tissue irritation if infused through a peripheral IV line. It is recommended to administer fluconazole through a central venous catheter to reduce the risk of complications. Choices A, B, and D are incorrect as there is no specific recommendation to administer the drug with lactated Ringer's, infuse it at a particular rate, or administer prophylactic heparin prior to fluconazole in this scenario.

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