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 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. In patients like the one described with a history of heart transplant and receiving long-term steroids, who are immunocompromised, live attenuated vaccines are contraindicated. Live vaccines contain weakened (attenuated) forms of the virus or bacteria, which can replicate and cause mild infections in healthy individuals but can lead to serious infections in immunocompromised individuals. Choices B, C, and D are incorrect because attenuated vaccines are not mutated, not inactive, and not pathogenic in healthy individuals, respectively.

3. A client with a history of hypertension presents with a severe headache and blurred vision. What is the nurse's priority action?

• A. Administer pain relief medication.
• B. Obtain a stat head CT scan.
• C. Administer antihypertensive medications as prescribed.
• D. Call the healthcare provider immediately.

Correct answer: C

Rationale: The correct answer is to administer antihypertensive medications as prescribed. In a client with a history of hypertension presenting with severe headache and blurred vision, these symptoms could indicate a hypertensive crisis. The priority action is to lower the blood pressure promptly to prevent complications such as stroke, heart attack, or organ damage. Administering antihypertensive medications is crucial in this situation. Administering pain relief medication (Choice A) may temporarily alleviate symptoms but does not address the underlying issue of elevated blood pressure. Obtaining a stat head CT scan (Choice B) may be necessary to rule out other causes but should not delay the administration of antihypertensive medications. Calling the healthcare provider immediately (Choice D) is important but may not address the immediate need to lower blood pressure in a hypertensive crisis.

4. A 75-year-old male presents with chest pain on exertion. The chest pain is most likely due to hypoxic injury secondary to:

• A. Malnutrition
• B. Free radicals
• C. Ischemia
• D. Chemical toxicity

Correct answer: C

Rationale: The correct answer is C: Ischemia. In this scenario, the 75-year-old male experiences chest pain on exertion, which is indicative of angina. Angina is primarily caused by reduced blood flow to the heart muscle, leading to hypoxic injury. This condition is known as ischemia. Options A, B, and D are incorrect. Malnutrition does not typically cause chest pain related to exertion. Free radicals and chemical toxicity are not common causes of chest pain in the context described. Therefore, the most likely cause of chest pain in this case is ischemia due to reduced blood flow.

5. A patient is prescribed acyclovir (Zovirax) for the treatment of genital herpes. What is the expected outcome of this medication?

• A. Decreased testosterone production
• B. Decreased libido
• C. Decreased viral shedding
• D. Decreased bacterial replication

Correct answer: C

Rationale: The expected outcome of acyclovir (Zovirax) for the treatment of genital herpes is decreased viral shedding. Acyclovir is an antiviral medication that works by inhibiting the replication of the herpes virus, thereby reducing viral shedding and helping to control outbreaks. Choice A, decreased testosterone production, and Choice B, decreased libido, are unrelated outcomes of acyclovir treatment for genital herpes. Choice D, decreased bacterial replication, is also incorrect as acyclovir specifically targets viruses and does not affect bacterial replication.

Similar Questions