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. What common symptom should be assessed in individuals with immunodeficiency?

• A. Anemia
• B. Recurrent infections
• C. Hypersensitivity
• D. Autoantibody production

Correct answer: B

Rationale: Recurrent infections are a hallmark symptom of immunodeficiency. Individuals with impaired immune systems are more susceptible to recurrent infections due to their compromised ability to fight off pathogens. Anemia (Choice A) is not a direct symptom of immunodeficiency but can be a consequence of chronic diseases. Hypersensitivity (Choice C) refers to exaggerated immune responses rather than impaired immune function. Autoantibody production (Choice D) is not typically a primary symptom of immunodeficiency but may be seen in certain autoimmune conditions.

3. A patient is prescribed dutasteride (Avodart) for benign prostatic hyperplasia (BPH). What outcome should the nurse expect to observe if the drug is having the desired effect?

• A. Decreased size of the prostate gland
• B. Increased urinary output
• C. Increased urine flow
• D. Decreased blood pressure

Correct answer: A

Rationale: The correct answer is A: Decreased size of the prostate gland. Dutasteride is a medication used for BPH to reduce the size of the prostate gland, thereby improving urinary flow and decreasing symptoms. Choice B, increased urinary output, is incorrect as dutasteride primarily targets the size of the prostate gland rather than directly affecting urinary output. Choice C, increased urine flow, is related to the expected outcome of dutasteride therapy but is not as direct as the reduction in the size of the prostate gland. Choice D, decreased blood pressure, is not an expected outcome of dutasteride therapy for BPH.

4. Which of the following statements indicates more teaching is needed regarding secondary lymph organs? ________is/are a secondary lymph organ.

• A. The spleen
• B. Peyer's patches
• C. Adenoids
• D. The liver

Correct answer: D

Rationale: The correct answer is D, 'The liver.' The liver is not a secondary lymph organ. Secondary lymph organs are primarily involved in the immune response, such as the spleen, Peyer's patches, and adenoids. The spleen filters blood and is essential for immune function. Peyer's patches are located in the small intestine and help protect against pathogens. Adenoids are located in the throat and play a role in immune defense. Therefore, the liver is the incorrect choice as it is not part of the secondary lymph organ system.

5. Which symptoms are typical of asthma?

• A. Chest pain; cough
• B. Diarrhea; wheezing
• C. Wheezing; dyspnea
• D. Tachypnea; constipation

Correct answer: C

Rationale: The correct answer is C: Wheezing and dyspnea are typical symptoms of asthma. Wheezing refers to a high-pitched whistling sound while breathing, and dyspnea is shortness of breath. These symptoms are classic signs of airway obstruction and inflammation seen in asthma. Choice A is incorrect as chest pain is not a typical symptom of asthma, though coughing can occur. Choice B is incorrect as diarrhea is not associated with asthma, while wheezing is a common symptom. Choice D is incorrect as tachypnea (rapid breathing) can occur in asthma, but constipation is not a typical symptom.

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