Nursing Elites

1. A newborn is diagnosed with congenital intrinsic factor deficiency. Which of the following types of anemia will the nurse see documented on the chart?

• A. Iron deficiency anemia
• B. Sideroblastic anemia
• C. Pernicious anemia
• D. Hemolytic anemia

Correct answer: C

Rationale: The correct answer is C, Pernicious anemia. Pernicious anemia is associated with a congenital intrinsic factor deficiency, leading to the impaired absorption of vitamin B12. Iron deficiency anemia (Choice A) is not directly related to intrinsic factor deficiency. Sideroblastic anemia (Choice B) is characterized by defective iron uptake by developing erythrocytes and is not linked to intrinsic factor deficiency. Hemolytic anemia (Choice D) involves the premature destruction of red blood cells and is not specifically associated with intrinsic factor deficiency.

2. A client presents to the emergency department with complaints of chest pain and shortness of breath. The client's ECG shows ST-segment elevation. What is the priority nursing intervention?

• A. Administer aspirin as prescribed.
• B. Prepare the client for emergent coronary angiography.
• C. Administer oxygen therapy.
• D. Initiate CPR.

Correct answer: B

Rationale: In a client presenting with chest pain, shortness of breath, and ST-segment elevation on ECG, the priority nursing intervention is to prepare the client for emergent coronary angiography. This procedure is crucial in diagnosing and treating acute myocardial infarction promptly. Administering aspirin (Choice A) is important but not the priority over emergent coronary angiography. Administering oxygen therapy (Choice C) is supportive but does not address the underlying cause of the ST-segment elevation. Initiating CPR (Choice D) is not the priority in this scenario as the client is stable and conscious.

3. Hematopoiesis occurs primarily in the bone marrow. What cells are formed during this process?

• A. Pancreatic beta cells
• B. Red blood cells
• C. Gastric parietal cells
• D. Neurons and glial cells

Correct answer: B

Rationale: The correct answer is B: Red blood cells. Hematopoiesis is the process of blood cell formation that primarily occurs in the bone marrow. Red blood cells are one of the main cell types formed during this process. Pancreatic beta cells (Choice A), gastric parietal cells (Choice C), and neurons and glial cells (Choice D) are not formed during hematopoiesis. Pancreatic beta cells are involved in insulin production, gastric parietal cells secrete gastric acid, and neurons and glial cells are part of the nervous system.

4. A patient is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the main rationale for administering these medications together?

• A. They improve treatment adherence.
• B. They reduce the duration of illness.
• C. They exhibit synergistic antiviral effects.
• D. They prevent opportunistic infections.

Correct answer: C

Rationale: The main rationale for administering a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor is that they exhibit synergistic antiviral effects when used together. This combination enhances their antiviral activity against HIV by targeting different steps in the viral replication cycle. Choice A is incorrect because the rationale for combining these medications is based on their antiviral effects, not treatment adherence. Choice B is incorrect because the primary purpose of combination therapy is not to reduce the duration of illness but to improve treatment efficacy. Choice D is incorrect as the main focus of this combination is not on preventing opportunistic infections but on directly targeting the HIV virus.

5. Which of the following are signs and symptoms of myocardial infarction?

• A. Persistent chest pain which may radiate to the arm
• B. Brief sternal chest pain on inspiration
• C. Rapid respirations with left-sided weakness and numbness
• D. Left upper quadrant abdominal pain which radiates to the back and shoulder

Correct answer: A

Rationale: The correct answer is A. Persistent chest pain that may radiate to the arm is a classic symptom of myocardial infarction. This pain is typically described as crushing, pressure-like, or squeezing. Choice B is incorrect because brief sternal chest pain on inspiration is not characteristic of myocardial infarction. Choice C is incorrect because rapid respirations with left-sided weakness and numbness are not typical symptoms of myocardial infarction. Choice D is incorrect because left upper quadrant abdominal pain that radiates to the back and shoulder is not a common presentation of myocardial infarction.

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