Nursing Elites

1. A client with Guillain-Barré syndrome is experiencing ascending paralysis. Which of the following interventions should the nurse prioritize?

• A. Monitor for signs of respiratory distress.
• B. Prepare the client for plasmapheresis.
• C. Administer analgesics for pain management.
• D. Initiate passive range-of-motion exercises.

Correct answer: A

Rationale: The correct answer is A: Monitor for signs of respiratory distress. In Guillain-Barré syndrome, ascending paralysis can lead to respiratory muscle involvement, putting the client at risk for respiratory distress and failure. Prioritizing respiratory monitoring is crucial to ensure timely intervention if respiratory compromise occurs. Plasmapheresis (Choice B) may be indicated in some cases to remove harmful antibodies, but the priority in this situation is respiratory support. Administering analgesics (Choice C) for pain management and initiating passive range-of-motion exercises (Choice D) are important aspects of care but are not the priority when the client's respiratory status is at risk.

2. What specific instructions should the nurse provide for proper administration of alendronate (Fosamax) in a patient with osteoporosis?

• A. Take the medication with milk to enhance calcium absorption.
• B. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent gastrointestinal upset.

Correct answer: B

Rationale: The correct answer is to take alendronate with a full glass of water and remain upright for at least 30 minutes. This is essential to prevent esophageal irritation and ensure proper drug absorption. Choice A is incorrect as alendronate should not be taken with milk due to potential interactions. Choice C is incorrect as there is no need to take the medication at bedtime specifically. Choice D is incorrect as taking alendronate with food can decrease its absorption.

3. In a 70-year-old man with a history of chronic obstructive pulmonary disease (COPD) reporting increasing shortness of breath, wheezing, and cough, which finding would indicate a potential exacerbation of his COPD?

• A. Increased wheezing
• B. Decreased respiratory rate
• C. Improved exercise tolerance
• D. Decreased sputum production

Correct answer: A

Rationale: The correct answer is A: Increased wheezing. In COPD exacerbations, there is a worsening of symptoms such as increased wheezing due to airway inflammation and narrowing. Choices B, C, and D are incorrect. Decreased respiratory rate would not be expected in COPD exacerbation as it is usually a compensatory mechanism to maintain oxygenation. Improved exercise tolerance is not a typical finding in exacerbations but rather a sign of improvement. Decreased sputum production is also not indicative of exacerbation, as exacerbations are often associated with increased sputum production.

4. Which of the following mediates humoral immunity?

• A. Natural killer cells
• B. T cells
• C. B cells
• D. Neutrophils

Correct answer: C

Rationale: Humoral immunity is mediated by B cells, not natural killer cells, T cells, or neutrophils. B cells are responsible for producing antibodies, which are essential components of humoral immunity.

5. A patient is being treated for a severe fungal infection with amphotericin B. What is the expected length of treatment for this patient?

• A. 1 to 2 weeks
• B. 3 to 6 weeks
• C. 4 to 12 weeks
• D. 15 to 18 weeks

Correct answer: C

Rationale: The correct answer is C: '4 to 12 weeks.' Amphotericin B treatment duration for severe fungal infections typically ranges from 4 to 12 weeks. This extended period is necessary to ensure complete eradication of the fungal infection and prevent relapse. Choices A, B, and D provide durations that are either too short or too long for treating severe fungal infections effectively, making them incorrect.

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