Nursing Elites

1. A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?

• A. Oral contraceptives can cause weight loss and increased energy levels.
• B. Oral contraceptives can cause increased appetite and weight gain.
• C. Oral contraceptives can cause headaches and breast tenderness.
• D. Oral contraceptives have no side effects.

Correct answer: C

Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.

2. A secondary immune response differs from the primary immune response in that:

• A. It is more rapid than the primary response and results in higher antibody levels
• B. It is slower than the primary response and doesn't change the antibody levels
• C. It occurs at the same time as the primary response but results in a decrease in antibodies
• D. It only occurs in hyperallergic reactions and results in a decrease in antibodies

Correct answer: A

Rationale: The correct answer is A. A secondary immune response is characterized by being more rapid than the primary response and results in higher antibody levels. This is because memory B cells are already present and can quickly differentiate into plasma cells upon re-exposure to the antigen. Choice B is incorrect because a secondary immune response is faster, not slower, than the primary response, and it does lead to higher antibody levels. Choice C is incorrect because a secondary response does not result in a decrease in antibodies; instead, it leads to an increase. Choice D is incorrect because a secondary immune response is not limited to hyperallergic reactions, and it results in an increase, not a decrease, in antibodies.

3. A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:

• A. is normal with no sickle cell disease.
• B. is a sickle cell carrier.
• C. has sickle cell anemia.
• D. has thalassemia.

Correct answer: B

Rationale: HbAS indicates sickle cell trait, not full-blown sickle cell anemia. Choice A is incorrect because HbAS indicates the presence of the sickle cell trait. Choice C is incorrect as sickle cell anemia is characterized by HbSS, not HbAS. Choice D is incorrect as thalassemia is a different type of hemoglobin disorder not indicated by HbAS.

4. Following the administration of her annual influenza vaccination, a health care worker remains at the clinic for observation due to pain at the injection site. What should the nurse recommend?

• A. ASA
• B. Acetaminophen
• C. Meperidine (Demerol)
• D. Heat application

Correct answer: B

Rationale: The correct recommendation for pain at the injection site after an influenza vaccination is Acetaminophen. Acetaminophen is a suitable choice for managing mild to moderate pain and fever commonly associated with vaccinations. Choice A, ASA (aspirin), is not recommended due to the risk of Reye's syndrome in children and teenagers following viral illnesses. Choice C, Meperidine (Demerol), is a potent opioid analgesic and is not typically indicated for mild pain relief. Choice D, heat application, is not the standard recommendation for pain at an injection site and may not provide adequate relief.

5. A 21-year-old female was recently diagnosed with iron deficiency anemia. In addition to fatigue and weakness, which of the following clinical signs and symptoms would she most likely exhibit?

• A. Hyperactivity
• B. Spoon-shaped nails
• C. Gait problems
• D. Petechiae

Correct answer: B

Rationale: The correct answer is B: Spoon-shaped nails. In iron deficiency anemia, spoon-shaped nails (koilonychia) are a common symptom due to changes in the nail bed. This condition is known as Plummer-Vinson syndrome. While fatigue and weakness are common in iron deficiency anemia, hyperactivity (choice A) is not typically associated with this condition. Gait problems (choice C) and petechiae (choice D) are more commonly seen in other medical conditions and are not characteristic of iron deficiency anemia.

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