Nursing Elites

1. A group of nursing students and their professor are engaged in a service learning project and will be caring for patients in Haiti. What medication should be administered to prevent the development of malaria?

• A. Metronidazole (Flagyl)
• B. Oprelvekin (Neumega)
• C. Chloroquine phosphate (Aralen)
• D. Chloroprocaine hydrochloride (Nesacaine)

Correct answer: C

Rationale: The correct answer is Chloroquine phosphate (Aralen). Chloroquine is a medication used to prevent and treat malaria. It works by killing the malaria parasite in the red blood cells. Metronidazole (Flagyl) is an antibiotic used to treat various bacterial and parasitic infections, not malaria. Oprelvekin (Neumega) is a medication used to stimulate platelet production. Chloroprocaine hydrochloride (Nesacaine) is a local anesthetic used for epidural anesthesia. Therefore, Chloroquine phosphate is the appropriate medication for preventing malaria in this scenario.

2. A 35-year-old female is diagnosed with vitamin B12 deficiency anemia (pernicious anemia). How should the nurse respond when the patient asks what causes pernicious anemia? A decrease in ______ is the most likely cause.

• A. Ferritin
• B. Gastric enzymes
• C. Intrinsic factor
• D. Erythropoietin

Correct answer: C

Rationale: Pernicious anemia is primarily caused by a decrease in intrinsic factor. Intrinsic factor is a protein produced by the stomach that is necessary for the absorption of vitamin B12 in the intestines. Without intrinsic factor, vitamin B12 cannot be absorbed properly, leading to anemia. Ferritin is a protein that stores iron in the body and is not directly related to pernicious anemia. Gastric enzymes play a role in digestion but are not the primary cause of pernicious anemia. Erythropoietin is a hormone produced by the kidneys to stimulate red blood cell production and is not linked to pernicious anemia.

3. A patient with a history of osteoporosis is prescribed raloxifene (Evista). What is the primary therapeutic action of this medication?

• A. It stimulates the formation of new bone.
• B. It decreases bone resorption and increases bone density.
• C. It increases calcium absorption in the intestines.
• D. It increases the excretion of calcium through the kidneys.

Correct answer: B

Rationale: The correct answer is B: 'It decreases bone resorption and increases bone density.' Raloxifene, as a selective estrogen receptor modulator (SERM), works by reducing bone resorption (breakdown) and maintaining or increasing bone density. This mechanism helps in preventing further bone loss and can even increase bone mass. Choices A, C, and D are incorrect. Raloxifene does not stimulate the formation of new bone (choice A), increase calcium absorption in the intestines (choice C), or increase the excretion of calcium through the kidneys (choice D).

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. A nurse is caring for a client with lung cancer who is experiencing dyspnea. Which intervention is most appropriate?

• A. Administer a cough suppressant to reduce discomfort.
• B. Encourage the client to lie flat to ease breathing.
• C. Provide supplemental oxygen therapy.
• D. Encourage deep breathing and coughing exercises.

Correct answer: C

Rationale: The most appropriate intervention for a client with lung cancer experiencing dyspnea is to provide supplemental oxygen therapy. This intervention helps improve oxygenation and alleviate breathing difficulties. Administering a cough suppressant (Choice A) may not address the underlying cause of dyspnea and can potentially depress the respiratory drive. Encouraging the client to lie flat (Choice B) can worsen dyspnea by reducing lung expansion. Encouraging deep breathing and coughing exercises (Choice D) may be beneficial in some situations, but when a client is experiencing dyspnea due to lung cancer, supplemental oxygen therapy is the priority to improve oxygen levels and alleviate breathing difficulty.

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