Nursing Elites

1. A 54-year-old man presents with a temperature of 38.8°C (101.8°F), a racing heart, fatigue, and an upset stomach after spending an afternoon building a deck on a very hot, humid day. The physician assessing the man is performing a differential diagnosis as part of her assessment. Which finding would suggest fever rather than hyperthermia as a cause of the elevation in the man's temperature?

• A. Absence of sweating
• B. Shivering
• C. Lack of thirst
• D. Increased heart rate

Correct answer: B

Rationale: Shivering is a physiological response to fever, as the body attempts to generate heat to increase the internal temperature. Hyperthermia, on the other hand, does not involve shivering. Absence of sweating (choice A) is more indicative of hyperthermia, as the body struggles to cool down without sweating. Lack of thirst (choice C) can be seen in both fever and hyperthermia. Increased heart rate (choice D) can occur in both fever and hyperthermia due to the body's attempt to regulate temperature.

2. How should rifampin most likely be administered to a patient diagnosed with tuberculosis?

• A. Orally, with food
• B. Orally, on an empty stomach
• C. Intramuscularly
• D. Intravenously, as a bolus

Correct answer: A

Rationale: Rifampin is typically administered orally, and it is recommended to be taken with food to enhance its absorption and reduce gastrointestinal side effects. Administering rifampin intramuscularly or intravenously is not the standard route of administration for this medication used in tuberculosis treatment.

3. A patient presents with a chronic cough, night sweats, and weight loss. A chest X-ray reveals upper lobe cavitary lesions. Which of the following is the most likely diagnosis?

• A. Tuberculosis
• B. Pneumonia
• C. Lung cancer
• D. Sarcoidosis

Correct answer: A

Rationale: The correct answer is A: Tuberculosis. Cavitary lesions in the upper lobes are classic findings seen in tuberculosis. This infectious disease commonly presents with symptoms such as chronic cough, night sweats, and weight loss. Pneumonia (Choice B) typically does not present with cavitary lesions on chest X-ray. Lung cancer (Choice C) may present with similar symptoms but is less likely to cause cavitary lesions in the upper lobes. Sarcoidosis (Choice D) usually presents with bilateral hilar lymphadenopathy and non-caseating granulomas, different from the cavitary lesions described in the case.

4. What is the treatment for patients with hemophilia A?

• A. Chemotherapy
• B. Factor VIII replacement
• C. Heparin administration
• D. Bone marrow transplant

Correct answer: B

Rationale: The correct treatment for patients with hemophilia A is Factor VIII replacement. Hemophilia A is a genetic disorder where there is a deficiency in clotting factor VIII. Therefore, replacing this factor is crucial in managing and preventing bleeding episodes. Choice A, chemotherapy, is not the correct treatment for hemophilia A. Choice C, heparin administration, is not recommended as it can further increase the risk of bleeding in patients with hemophilia. Choice D, bone marrow transplant, is not a standard treatment for hemophilia A.

5. Why is it important for a patient to take a new oral contraceptive at the same time each day?

• A. Taking the medication at the same time each day helps maintain stable hormone levels, which is critical for preventing pregnancy.
• B. Taking the medication at the same time each day reduces the risk of breakthrough bleeding.
• C. Taking the medication at the same time each day ensures consistent absorption and effectiveness.
• D. Taking the medication at the same time each day is important, but missing a dose occasionally is not a concern.

Correct answer: A

Rationale: The correct answer is A. Taking oral contraceptives at the same time each day is crucial for maintaining stable hormone levels, which is essential for the contraceptive's effectiveness in preventing pregnancy. Choice B is incorrect because the primary reason for taking the medication consistently is hormone level stability, not specifically to reduce breakthrough bleeding. Choice C is incorrect as it focuses on absorption and effectiveness, which are important but do not address the main reason for consistent timing. Choice D is incorrect because missing doses can impact contraceptive efficacy, making consistent timing essential for optimal protection.

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