Nursing Elites

1. 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.

2. A client is admitted with a suspected aortic dissection. What is the priority nursing intervention?

• A. Administer antihypertensive medications as prescribed.
• B. Prepare the client for emergency surgery.
• C. Administer intravenous fluids to maintain blood pressure.
• D. Monitor the client's urine output closely.

Correct answer: B

Rationale: The correct answer is B: Prepare the client for emergency surgery. Aortic dissection is a life-threatening emergency that often necessitates immediate surgical intervention to prevent rupture and further complications. Administering antihypertensive medications (choice A) may be necessary but is not the priority over surgical intervention. While maintaining blood pressure with intravenous fluids (choice C) is important, the urgent need for surgery takes precedence. Monitoring urine output (choice D) is essential for assessing renal function but is not the priority in this critical situation.

3. What should the nurse include in patient education regarding the effectiveness of oral contraceptives?

• A. Oral contraceptives are highly effective when taken correctly but not 100% foolproof.
• B. Oral contraceptives may take some time to reach full effectiveness after starting.
• C. Oral contraceptives can be less effective if taken with certain antibiotics.
• D. Taking oral contraceptives with food does not significantly affect their efficacy.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics due to potential drug interactions that may reduce contraceptive efficacy. It is crucial for patients to be aware of this to consider additional contraceptive measures when prescribed antibiotics. Choice A is incorrect because while oral contraceptives are highly effective when taken correctly, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is also incorrect as taking oral contraceptives with food does not significantly affect their efficacy.

4. 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.

5. A patient is receiving intravenous amphotericin. Which of the following assessments warrants the discontinuation of the antifungal agent?

• A. Sodium level of 138 mEq/L
• B. Hematocrit of 39%
• C. Blood urea nitrogen of 60 mg/dL
• D. AST level of 10 Unit/L

Correct answer: C

Rationale: Intravenous amphotericin can cause nephrotoxicity, leading to increased blood urea nitrogen levels. Elevated blood urea nitrogen (BUN) indicates impaired renal function, which is a known adverse effect of amphotericin. Therefore, a BUN level of 60 mg/dL warrants the discontinuation of the antifungal agent. The other options, such as a sodium level of 138 mEq/L, hematocrit of 39%, and AST level of 10 Unit/L, are within normal ranges and not indicative of the need to discontinue amphotericin therapy.

Similar Questions