Nursing Elites

1. Which of the following cell types would be the first to aid in killing bacteria to prevent infection in his hand?

• A. Eosinophils
• B. Neutrophils
• C. Leukotrienes
• D. Monocytes

Correct answer: B

Rationale: Neutrophils are the first responders to a bacterial infection. They are phagocytes that engulf and destroy bacteria, playing a crucial role in the early stages of the immune response. Eosinophils are primarily involved in combating parasitic infections and allergic reactions, not bacterial infections. Leukotrienes are signaling molecules that contribute to inflammation and immune responses, but they are not cells. Monocytes are another type of white blood cell that differentiates into macrophages and dendritic cells, playing a role in immune response but not as immediate as neutrophils.

2. Abrupt withdrawal or discontinuation of prednisone can cause:

• A. adrenal crisis.
• B. hypercortisolism.
• C. ACTH stimulation.
• D. thyroid crisis.

Correct answer: A

Rationale: The correct answer is A: adrenal crisis. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, resulting in adrenal crisis. Prednisone is a corticosteroid that suppresses the adrenal glands' ability to produce cortisol. Abrupt withdrawal can cause a sudden drop in cortisol levels, leading to adrenal crisis with symptoms like fatigue, weakness, abdominal pain, and potentially life-threatening low blood pressure. Choices B, C, and D are incorrect because hypercortisolism refers to excess cortisol levels, ACTH stimulation would not result from prednisone withdrawal, and thyroid crisis is not directly related to corticosteroid discontinuation.

3. When assessing a patient experiencing breakthrough bleeding while taking oral contraceptives, what should the nurse consider?

• A. The possibility of pregnancy
• B. The patient's adherence to the medication schedule
• C. The need for an increased dosage
• D. The effectiveness of the current oral contraceptive

Correct answer: B

Rationale: When a patient on oral contraceptives experiences breakthrough bleeding, it is crucial for the nurse to consider the patient's adherence to the medication schedule. Breakthrough bleeding is often a sign of missed doses or inconsistent use, which can decrease the effectiveness of the oral contraceptive. Considering the possibility of pregnancy (Choice A) is important but secondary to assessing adherence. The need for an increased dosage (Choice C) is not typically the first consideration for breakthrough bleeding. Evaluating the effectiveness of the current oral contraceptive (Choice D) is relevant but should come after assessing adherence to the medication schedule.

4. 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.

5. What are direct effects of antibodies? (Select ONE that does not apply):

• A. Neutralization
• B. Agglutination
• C. Precipitation
• D. Phagocytosis

Correct answer: D

Rationale: The direct effects of antibodies include neutralization, agglutination, and precipitation. Antibodies neutralize pathogens by binding to them and preventing their harmful effects. Agglutination involves the clumping together of pathogens, making it easier for phagocytes to engulf them. Precipitation refers to the process where antibodies bind to soluble antigens, forming large complexes that are easily removed from the body. Phagocytosis, on the other hand, is an indirect effect of antibodies where phagocytes engulf and destroy pathogens opsonized by antibodies, not a direct effect.

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