Nursing Elites

1. When a client reports being allergic to penicillin, which question should the nurse ask to gather more information?

• A. Are you allergic to any other medications?
• B. How often have you taken penicillin in the past?
• C. Is anyone else in your family allergic to penicillin?
• D. What happens to you when you take penicillin?

Correct answer: D

Rationale: Questioning the client about the specific allergic reaction to penicillin is crucial for assessing the severity and type of allergic response, aiding in determining appropriate treatment and avoiding potential adverse reactions.

2. A 28-year-old woman presents with abdominal pain, bloating, and diarrhea. She notes that her symptoms improve with fasting. She has a history of iron deficiency anemia. What is the most likely diagnosis?

• A. Irritable bowel syndrome
• B. Celiac disease
• C. Lactose intolerance
• D. Crohn's disease

Correct answer: B

Rationale: The symptoms of abdominal pain, bloating, diarrhea improving with fasting, and a history of iron deficiency anemia are characteristic of celiac disease. Celiac disease is an autoimmune disorder triggered by gluten consumption, leading to damage in the small intestine. The improvement with fasting may be due to the temporary avoidance of gluten-containing foods. Irritable bowel syndrome, lactose intolerance, and Crohn's disease do not typically present with improvement of symptoms with fasting or have a clear association with iron deficiency anemia.

3. A client in acute renal failure has a serum potassium level of 6.3 mEq/L. What intervention can the nurse expect the healthcare provider to prescribe?

• A. Nitrofurantoin (Macrodantin) orally.
• B. Erythropoietin (Epogen) intravenously.
• C. Kayexalate retention enema.
• D. Azathioprine (Imuran) orally.

Correct answer: C

Rationale: In acute renal failure with high serum potassium levels, the healthcare provider is likely to prescribe a Kayexalate retention enema. Kayexalate is a medication used to lower elevated potassium levels by promoting potassium excretion through the gastrointestinal tract, thus aiding in the management of hyperkalemia in clients with renal failure.

4. In a patient with chronic kidney disease (CKD) receiving erythropoietin therapy, what laboratory result should the nurse monitor to evaluate the effectiveness of this therapy?

• A. Serum creatinine
• B. White blood cell count
• C. Hemoglobin level
• D. Serum potassium

Correct answer: C

Rationale: The correct answer is C: Hemoglobin level. Erythropoietin therapy is used to stimulate red blood cell production in patients with chronic kidney disease who often develop anemia due to reduced erythropoietin production by the kidneys. Monitoring the hemoglobin level is essential to evaluate the effectiveness of erythropoietin therapy as an increase in hemoglobin indicates improved red blood cell production and better management of anemia in these patients. Serum creatinine, white blood cell count, and serum potassium levels are important parameters to monitor in CKD patients but are not specific indicators of the effectiveness of erythropoietin therapy for managing anemia.

5. A 75-year-old patient is admitted for pancreatitis. Which tool would be the most appropriate for the nurse to use during the admission assessment?

• A. Drug Abuse Screening Test (DAST-10)
• B. Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)
• C. Screening Test-Geriatric Version (SMAST-G)
• D. Mini-Mental State Examination

Correct answer: C

Rationale: The most appropriate tool for the nurse to use during the admission assessment of a 75-year-old patient admitted for pancreatitis is the Screening Test-Geriatric Version (SMAST-G). Since alcohol abuse is a common factor associated with pancreatitis, screening for alcohol use is crucial. The SMAST-G is a validated short-form alcoholism screening instrument tailored for older adults. If the patient screens positively on the SMAST-G, then the CIWA-Ar would be useful for further assessment. The Drug Abuse Screening Test (DAST-10) provides information on substance use in general, not specific to alcohol. The Mini-Mental State Examination is used to assess cognitive function, not alcohol abuse.

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