Nursing Elites

1. A hemoglobin electrophoresis is done to evaluate for sickle cell disease. The report reveals the person has HbAS, which means the person:

• A. is normal with no sickle cell disease.
• B. is a sickle cell carrier.
• C. has sickle cell anemia.
• D. has thalassemia.

Correct answer: B

Rationale: HbAS indicates sickle cell trait, not full-blown sickle cell anemia. Choice A is incorrect because HbAS indicates the presence of the sickle cell trait. Choice C is incorrect as sickle cell anemia is characterized by HbSS, not HbAS. Choice D is incorrect as thalassemia is a different type of hemoglobin disorder not indicated by HbAS.

2. 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.

3. A patient's current medical condition is suggestive of impaired erythropoiesis. Which of the following laboratory studies would be most clinically relevant in diagnosing this health problem?

• A. White blood cell count with differential
• B. RBC, hemoglobin, and hematocrit
• C. INR and aPTT
• D. d-dimer and C-reactive protein

Correct answer: B

Rationale: In this scenario, where impaired erythropoiesis is suspected, the most clinically relevant laboratory studies would focus on red blood cell parameters. Therefore, assessing RBC count, hemoglobin levels, and hematocrit values would provide direct insights into erythropoiesis. Choices A, C, and D are not directly related to erythropoiesis assessment. White blood cell count with a differential is more indicative of immune response and infection. INR and aPTT are coagulation studies, while d-dimer and C-reactive protein levels are more associated with inflammation and thrombotic events.

4. A client with a history of deep vein thrombosis (DVT) is receiving anticoagulant therapy. Which complication should the nurse monitor for?

• A. Pulmonary embolism
• B. Gastrointestinal bleeding
• C. Hemorrhagic stroke
• D. Renal insufficiency

Correct answer: A

Rationale: The correct answer is A, pulmonary embolism. In a client with a history of deep vein thrombosis (DVT) receiving anticoagulant therapy, the nurse should monitor for pulmonary embolism, as it is a serious complication. Pulmonary embolism occurs when a blood clot dislodges from the veins and travels to the lungs, potentially causing life-threatening consequences. Choices B, gastrointestinal bleeding, C, hemorrhagic stroke, and D, renal insufficiency, are not directly associated with deep vein thrombosis or anticoagulant therapy. While these complications may occur in other situations, they are not the primary concern when managing a client with a history of DVT.

5. A student is feeling inside her backpack to find her mobile phone. There are a number of other items in the bag other than the phone. The nurse knows that which term best describes one's ability to sense the shape and size of an object in the absence of visualization?

• A. Stereognosis
• B. Graphesthesia
• C. Proprioception
• D. Kinesthesia

Correct answer: A

Rationale: Stereognosis is the correct answer. It refers to the ability to recognize objects by touch, specifically determining their shape and size without relying on visual cues. Graphesthesia, on the other hand, is the ability to recognize symbols or numbers traced on the skin. Proprioception involves the awareness of body position and movement. Kinesthesia relates to the perception of body movement.

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