Nursing Elites

1. A client with atrial fibrillation is at risk for which of the following complications?

• A. Deep vein thrombosis (DVT)
• B. Pulmonary embolism
• C. Hypertensive crisis
• D. Myocardial infarction

Correct answer: B

Rationale: Corrected Rationale: A client with atrial fibrillation is at increased risk of thromboembolism due to blood stasis in the atria. This can lead to the formation of blood clots, which may travel to the lungs and cause a pulmonary embolism. Pulmonary embolism is a serious complication of atrial fibrillation. Choices A, C, and D are incorrect because while atrial fibrillation can lead to complications such as stroke or heart failure, it is specifically associated with an increased risk of pulmonary embolism due to the clot formation associated with the condition.

2. A teacher in a preschool is diagnosed with giardiasis. Which of the following medications will be administered to treat the diarrhea and abdominal distention?

• A. Sulfasalazine (Azulfidine)
• B. Metronidazole (Flagyl)
• C. Trimethoprim–sulfamethoxazole (Bactrim)
• D. Doxycycline (Vibramycin)

Correct answer: B

Rationale: The correct answer is B. Metronidazole (Flagyl) is the drug of choice for treating giardiasis, which is a common cause of diarrhea and abdominal distention. Sulfasalazine (Choice A) is used to treat inflammatory bowel disease. Trimethoprim–sulfamethoxazole (Choice C) is commonly used for urinary tract infections and Pneumocystis jirovecii pneumonia. Doxycycline (Choice D) is commonly used to treat various bacterial infections but is not the first-line treatment for giardiasis.

3. A patient who was frequently homeless over the past several years has begun a drug regimen consisting solely of isoniazid (INH). What is this patient's most likely diagnosis?

• A. Active tuberculosis
• B. Latent tuberculosis
• C. Mycobacterium avium complex
• D. Human immunodeficiency virus

Correct answer: A

Rationale: The correct answer is A: Active tuberculosis. Given the patient's history of homelessness and initiation of isoniazid (INH) treatment, the most likely diagnosis is active tuberculosis. Isoniazid is a first-line medication used in the treatment of active tuberculosis. Latent tuberculosis (choice B) would not typically necessitate treatment with isoniazid alone. Mycobacterium avium complex (choice C) is not typically treated with isoniazid alone. Human immunodeficiency virus (choice D) is a risk factor for developing tuberculosis but is not the primary diagnosis in this patient scenario.

4. A female patient has been diagnosed with tuberculosis and begun multiple-drug therapy. The woman has asked the nurse why it is necessary for her to take several different drugs instead of one single drug. How should the nurse best respond to the patient's question?

• A. “Multiple drugs are used because doctors need to combat the TB bacteria from different angles to effectively treat the infection.”
• B. “The use of multiple drugs prevents the development of drug-resistant TB.”
• C. “Multiple drugs are prescribed because the final testing results for TB can take up to 3 weeks to confirm the most effective treatment.”
• D. “Multiple drugs are used in order to speed up the course of treatment.”

Correct answer: B

Rationale: The correct answer is B. Using multiple drugs in tuberculosis treatment helps prevent the development of drug-resistant TB. This approach is crucial because if the infection is not completely eradicated, the remaining bacteria may become resistant to the single drug used, making future treatments less effective. Choice A is incorrect because the use of multiple drugs is not due to uncertainty about which drug will work, but rather to address the bacteria from different angles. Choice C is incorrect as it misleads the patient about the reason for using multiple drugs. Choice D is also incorrect because the primary purpose of using multiple drugs is not to speed up treatment but to ensure effectiveness and prevent resistance.

5. A client with cystic fibrosis is admitted with a pulmonary exacerbation. Which intervention should the nurse prioritize?

• A. Administer a high-calorie, high-protein diet.
• B. Initiate airway clearance techniques.
• C. Encourage the client to maintain an active lifestyle.
• D. Monitor for signs of respiratory distress.

Correct answer: B

Rationale: During a pulmonary exacerbation in cystic fibrosis, the priority intervention is to initiate airway clearance techniques. These techniques help clear mucus from the airways, improving ventilation and reducing the risk of respiratory complications. Administering a high-calorie, high-protein diet is beneficial for overall nutrition but is not the priority during an exacerbation. Encouraging an active lifestyle is important for long-term health but does not address the immediate need for managing exacerbations. Monitoring for signs of respiratory distress is important, but initiating airway clearance techniques takes precedence in the management of pulmonary exacerbations in cystic fibrosis.

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