Nursing Elites

1. What is the primary role of albumin in the blood?

• A. Transport oxygen throughout the body.
• B. Serve as a key clotting factor.
• C. Maintain osmotic pressure and fluid balance.
• D. Act as an immune response molecule.

Correct answer: C

Rationale: The correct answer is C: Maintain osmotic pressure and fluid balance. Albumin plays a crucial role in maintaining osmotic pressure by helping to retain fluid within the blood vessels. This function is essential for regulating blood volume and preventing fluid from leaking out into tissues. Choices A, B, and D are incorrect because albumin is not primarily responsible for transporting oxygen, acting as a clotting factor, or functioning as an immune response molecule in the blood.

2. In which patient is alpha-1 antitrypsin deficiency the likely cause of chronic obstructive pulmonary disease?

• A. A 30-year-old who has smoked for 3 years
• B. A 65-year-old man who drove a taxi most of his life
• C. A 70-year-old woman who smoked for 40 years
• D. A 50-year-old with exposure to secondhand smoke

Correct answer: A

Rationale: Alpha-1 antitrypsin deficiency is a genetic cause of chronic obstructive pulmonary disease (COPD). It is more common in younger patients with a history of smoking at a younger age, like the 30-year-old who has smoked for 3 years. Choices B, C, and D are less likely to be associated with alpha-1 antitrypsin deficiency as COPD in these cases is more likely due to smoking and environmental exposures.

3. In a patient with HIV infected with Mycobacterium avium complex from an indoor pool, which of the following medications is the recommended treatment for MAC?

• A. Clarithromycin
• B. Isoniazid (INH)
• C. Rifabutin
• D. Azithromycin

Correct answer: A

Rationale: The correct answer is Clarithromycin. Clarithromycin is one of the recommended medications for treating Mycobacterium avium complex (MAC) infections in patients with HIV. It is a macrolide antibiotic that is effective against MAC. Isoniazid (INH) is used to treat tuberculosis, not MAC. Rifabutin is another medication used in the treatment of MAC infections, but clarithromycin is preferred as a first-line agent. Azithromycin is also used in the treatment of MAC infections; however, clarithromycin is more commonly recommended due to its efficacy and safety profile.

4. What is a common factor related to all forms of heart failure?

• A. Peripheral edema
• B. Pulmonary edema
• C. Reduced cardiac output
• D. Jugular vein distention

Correct answer: C

Rationale: The correct answer is C: Reduced cardiac output. All forms of heart failure share this common factor, which occurs when the heart is unable to pump enough blood to meet the body's needs. Choices A, B, and D are incorrect. While peripheral edema and pulmonary edema can be symptoms of heart failure, they are not universal to all forms. Jugular vein distention is a sign of right heart failure, not a common factor across all types of heart failure.

5. A patient is starting on oral contraceptives. What should the nurse emphasize about the importance of taking the medication at the same time each day?

• A. Taking the medication at the same time each day helps maintain stable hormone levels and ensures effectiveness.
• B. Taking the medication at the same time each day reduces the risk of breakthrough bleeding.
• C. Taking the medication at the same time each day ensures consistent absorption and effectiveness.
• D. Taking the medication at the same time each day is important, but missing a dose occasionally is not a concern.

Correct answer: A

Rationale: The correct answer is A. Taking oral contraceptives at the same time each day helps maintain stable hormone levels and ensures their effectiveness in preventing pregnancy. Choice B is incorrect because the primary emphasis of consistent timing is on hormone levels and effectiveness, not on reducing breakthrough bleeding. Choice C is incorrect because while consistent absorption is a factor, the main focus is on maintaining stable hormone levels. Choice D is incorrect as missing doses can significantly impact contraceptive efficacy.

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