Nursing Elites

1. A 5-month-old child is admitted to the hospital with recurring respiratory infections. A possible cause of this condition is:

• A. Hypergammaglobulinemia
• B. Increased maternal IgG
• C. Immune insufficiency
• D. Decreased maternal antibody breakdown, resulting in hyposensitivity

Correct answer: C

Rationale: Immune insufficiency is a possible cause of recurring respiratory infections in a 5-month-old child. In this scenario, the child's immune system may not be functioning optimally, leading to a susceptibility to infections. Choices A, B, and D are incorrect. Hypergammaglobulinemia refers to high levels of gamma globulins in the blood and is not typically associated with recurring respiratory infections in this context. Increased maternal IgG would provide passive immunity to the child, offering some protection against infections. Decreased maternal antibody breakdown leading to hyposensitivity is not a common cause of recurring respiratory infections in a 5-month-old child.

2. A 43-year-old man has tested positive for systemic candidiasis, and the care team has decided on IV fluconazole as a first-line treatment. When administering this medication, the nurse should

• A. administer the drug with lactated Ringer's.
• B. infuse the drug no faster than 200 mg/h.
• C. avoid administering the drug through a peripheral IV.
• D. administer prophylactic heparin prior to the fluconazole.

Correct answer: C

Rationale: When administering IV fluconazole, the nurse should avoid administering the drug through a peripheral IV. Fluconazole is known to cause phlebitis and tissue irritation if infused through a peripheral IV line. It is recommended to administer fluconazole through a central venous catheter to reduce the risk of complications. Choices A, B, and D are incorrect as there is no specific recommendation to administer the drug with lactated Ringer's, infuse it at a particular rate, or administer prophylactic heparin prior to fluconazole in this scenario.

3. A client with a history of chronic alcoholism presents to the emergency department with a complaint of double vision. Which cranial nerve is most likely involved?

• A. Cranial nerve I (Olfactory)
• B. Cranial nerve III (Oculomotor)
• C. Cranial nerve VI (Abducens)
• D. Cranial nerve VII (Facial)

Correct answer: C

Rationale: The correct answer is Cranial nerve VI (Abducens). Chronic alcoholism can lead to damage to the abducens nerve, which controls the lateral movement of the eye. This damage can result in symptoms like double vision. Cranial nerve I (Olfactory) is responsible for the sense of smell and is not related to eye movement. Cranial nerve III (Oculomotor) controls most of the eye movements but is less likely to be affected in chronic alcoholism than the abducens nerve. Cranial nerve VII (Facial) is responsible for facial movements and is not associated with double vision.

4. A patient with systemic candidiasis has been prescribed flucytosine. The nurse should be aware of the need to administer this drug with which of the following?

• A. Vitamin D and calcium supplements
• B. Fluconazole (Diflucan)
• C. Amphotericin B
• D. Penicillin G

Correct answer: C

Rationale: The correct answer is C: Amphotericin B. When treating systemic candidiasis, Amphotericin B is the drug of choice, not flucytosine. Amphotericin B is an antifungal medication used to treat severe fungal infections like systemic candidiasis. Choices A, B, and D are incorrect because vitamin D and calcium supplements, fluconazole, and penicillin G are not the drugs of choice for treating systemic candidiasis.

5. An 8-year-old boy has been diagnosed with a sex hormone deficiency and has begun a course of treatment with testosterone. What change in the boy's health status would necessitate a stop to the course of treatment?

• A. Excessive growth in height
• B. Signs of puberty
• C. Recurrent urinary tract infections
• D. Increased blood pressure

Correct answer: B

Rationale: In an 8-year-old boy with a sex hormone deficiency being treated with testosterone, the appearance of signs of puberty would necessitate stopping the treatment. Testosterone therapy in this case aims to supplement the deficient sex hormones but should not trigger premature puberty. Excessive growth in height (choice A) is not a typical reason to stop testosterone therapy. Recurrent urinary tract infections (choice C) and increased blood pressure (choice D) are not directly related to testosterone therapy in this context.

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