Nursing Elites

1. Which of the following nursing diagnoses would provide the most plausible indication for the use of epoetin alfa (Epogen) in a patient with renal failure?

• A. Risk for infection related to decreased erythropoiesis
• B. Activity intolerance related to decreased oxygen-carrying capacity
• C. Powerlessness related to sequelae of renal failure
• D. Ineffective breathing pattern related to inadequate erythropoietin synthesis

Correct answer: B

Rationale: The correct answer is B. In a patient with renal failure, the use of epoetin alfa (Epogen) is primarily aimed at addressing the decreased oxygen-carrying capacity due to impaired erythropoiesis. Epoetin alfa is a medication that stimulates red blood cell production, thereby improving the oxygen-carrying capacity of the blood. This would directly address the activity intolerance commonly seen in patients with renal failure. Choices A, C, and D are incorrect because they do not directly relate to the primary purpose of using epoetin alfa in this context. Risk for infection, powerlessness, and ineffective breathing pattern are important considerations in the care of a patient with renal failure, but they are not the primary indications for using epoetin alfa.

2. A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?

• A. Human immunodeficiency virus
• B. Drug-resistant tuberculosis
• C. Methicillin-resistant Staphylococcus aureus
• D. Vancomycin-resistant Staphylococcus aureus

Correct answer: B

Rationale: When a patient with active tuberculosis is not responding to antitubercular drug therapy, drug-resistant tuberculosis should be suspected. Drug-resistant tuberculosis occurs when the bacteria causing tuberculosis become resistant to the medications being used. Choices A, C, and D are incorrect because the scenario described does not align with HIV infection, methicillin-resistant Staphylococcus aureus, or vancomycin-resistant Staphylococcus aureus.

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

• A. Liver function tests
• B. Kidney function tests
• C. Prostate-specific antigen (PSA)
• D. Complete blood count (CBC)

Correct answer: A

Rationale: During androgen therapy for hypogonadism, it is important to monitor liver function tests. Androgens can affect the liver, potentially leading to liver dysfunction. Monitoring liver function tests helps in early detection of any liver abnormalities. Kidney function tests (Choice B) are not typically affected by androgen therapy. Prostate-specific antigen (PSA) levels (Choice C) may be monitored for conditions like prostate cancer, but it is not directly related to androgen therapy for hypogonadism. A complete blood count (CBC) (Choice D) may not show specific changes related to androgen therapy for hypogonadism.

4. Which of the following describes inflammation of the bladder lining?

• A. Incontinence
• B. Pyelonephritis
• C. Urinary calculi
• D. Cystitis

Correct answer: D

Rationale: The correct answer is D, Cystitis. Cystitis specifically refers to the inflammation of the bladder lining. Choice A, Incontinence, refers to the loss of bladder control and is not related to inflammation. Choice B, Pyelonephritis, is the inflammation of the kidney and renal pelvis, not the bladder lining. Choice C, Urinary calculi, refers to the formation of stones in the urinary tract and is not related to bladder inflammation.

5. After a thoracentesis on a client with a pleural effusion, which nursing intervention is most important post-procedure?

• A. Monitor for signs of infection.
• B. Assess for signs of bleeding or hematoma.
• C. Monitor vital signs and respiratory status.
• D. Instruct the client to rest and limit physical activity.

Correct answer: B

Rationale: The correct answer is to assess for signs of bleeding or hematoma. After a thoracentesis, it is crucial to monitor for any bleeding or hematoma formation at the puncture site, as this can lead to complications. Monitoring for signs of infection (Choice A) is essential but is usually a delayed concern compared to the immediate risk of bleeding post-procedure. While monitoring vital signs and respiratory status (Choice C) is important, assessing for bleeding takes precedence to address any immediate complications. Instructing the client to rest and limit physical activity (Choice D) is relevant for general post-procedure care but is not the most critical intervention in this scenario.

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