Nursing Elites

1. A 40-year-old man has been living with HIV for several years but experienced a significant decrease in his CD4+ levels a few months ago. The patient has just been diagnosed with Mycobacterium avium complex disease. The nurse should anticipate administering which of the following medications?

• A. Clarithromycin
• B. Pyrazinamide
• C. Rifapentine (Priftin)
• D. Azithromycin

Correct answer: A

Rationale: The correct answer is A: Clarithromycin. In the case of Mycobacterium avium complex disease, a common treatment regimen includes a macrolide antibiotic like clarithromycin or azithromycin in combination with other antimicrobials. Clarithromycin is a key component of the treatment due to its effectiveness against Mycobacterium avium complex. Choice B (Pyrazinamide) is not typically part of the standard treatment for this condition. Choice C (Rifapentine) is mainly used in tuberculosis treatment and is not a primary agent for Mycobacterium avium complex disease. Choice D (Azithromycin) is another suitable macrolide antibiotic for treating Mycobacterium avium complex disease but is not the medication typically used first-line.

2. After ingestion of cysts, how long does it take for the symptoms of giardiasis to develop?

• A. 12 to 24 hours
• B. 3 to 5 days
• C. 1 to 2 weeks
• D. 2 to 3 months

Correct answer: B

Rationale: Giardiasis symptoms typically develop 3 to 5 days after ingestion of the cysts. This timeframe aligns with the incubation period of the Giardia parasite. Choice A (12 to 24 hours) is too short for giardiasis to manifest. Choice C (1 to 2 weeks) and choice D (2 to 3 months) represent durations that are not consistent with the usual onset of symptoms in giardiasis.

3. A patient is diagnosed with type 2 diabetes mellitus. Which of the following is a common initial treatment strategy?

• A. Insulin therapy
• B. Lifestyle modification and metformin
• C. Sulfonylureas
• D. Thiazolidinediones

Correct answer: B

Rationale: The correct answer is B: Lifestyle modification and metformin. When managing type 2 diabetes mellitus, initial treatment often involves lifestyle changes such as adopting a healthy diet and increasing physical activity, along with the oral medication metformin. Insulin therapy (choice A) is usually reserved for cases where lifestyle changes and oral medications are not sufficient to control blood sugar levels. Sulfonylureas (choice C) and thiazolidinediones (choice D) are also oral medications used in diabetes management, but they are not typically recommended as first-line treatments due to various side effects and considerations in type 2 diabetes management.

4. A 5-year-old male presents with low-set ears, a fish-shaped mouth, and involuntary rapid muscular contraction. Laboratory testing reveals decreased calcium levels. Which of the following diagnoses is most likely?

• A. B cell deficiency
• B. T cell deficiency
• C. Combined immunodeficiency
• D. Complement deficiency

Correct answer: B

Rationale: The correct answer is B: T cell deficiency. The symptoms described in the case, including low-set ears, a fish-shaped mouth, involuntary rapid muscular contraction, and decreased calcium levels, are indicative of DiGeorge syndrome. This syndrome is characterized by T cell deficiency due to thymic hypoplasia. B cell deficiency (Choice A), combined immunodeficiency (Choice C), and complement deficiency (Choice D) do not align with the clinical presentation and laboratory findings provided in the case. Therefore, T cell deficiency is the most likely diagnosis in this scenario.

5. 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.

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