Nursing Elites

1. A nurse recalls an example of an immune-complex-mediated disease is:

• A. Bronchial asthma
• B. Contact dermatitis
• C. Serum sickness
• D. Rheumatoid arthritis

Correct answer: C

Rationale: The correct answer is C: Serum sickness. Serum sickness is characterized by the formation of immune complexes in response to certain medications or proteins. These immune complexes can deposit in tissues, leading to inflammation and tissue damage. Bronchial asthma (Choice A) is a chronic inflammatory condition of the airways not primarily mediated by immune complexes. Contact dermatitis (Choice B) is a type IV hypersensitivity reaction mediated by T cells, not immune complexes. Rheumatoid arthritis (Choice D) is an autoimmune disease where antibodies target self-antigens, but it is not primarily mediated by immune complexes.

2. A woman is complaining that she feels like the room is spinning even though she is not moving. Which of the following is characteristic of benign positional vertigo?

• A. It usually occurs with a headache.
• B. Pupillary changes are common.
• C. It is usually triggered when the patient bends forward.
• D. Nystagmus continues even when eyes fixate on an object.

Correct answer: C

Rationale: Benign positional vertigo is typically triggered by changes in head position, such as bending forward or turning over in bed. This change in position leads to brief episodes of vertigo, often associated with nystagmus, which is rapid, involuntary eye movements. Pupillary changes and headaches are not typical features of benign positional vertigo, making choices B and A incorrect. Nystagmus in benign positional vertigo usually stops when the eyes fixate on an object, so choice D is also incorrect.

3. A patient who is undergoing treatment for cytomegalovirus received his first dose of IV ganciclovir 3 days ago. When reviewing this patient's most recent blood work, what abnormality should the nurse most likely attribute to the use of this drug?

• A. Hemoglobin 17 g/dL (high normal)
• B. INR 3.8 (high)
• C. Platelet count 118,000/mm3 (low)
• D. Leukocytes 11,900/mm3 (high)

Correct answer: C

Rationale: The correct answer is C: Platelet count 118,000/mm3 (low). Ganciclovir, used to treat cytomegalovirus, is known to cause bone marrow suppression, leading to decreased platelet count (thrombocytopenia). This condition can increase the risk of bleeding. Choices A, B, and D are not typically associated with ganciclovir therapy. High hemoglobin levels (choice A) are not commonly seen with ganciclovir treatment. INR elevation (choice B) is associated with coagulation abnormalities, which are not a typical side effect of ganciclovir. Elevated leukocyte count (choice D) is not a common consequence of ganciclovir use.

4. Which of the following describes inflammation of the bladder lining?

• A. Incontinence
• B. Pyelonephritis
• C. Urinary calculi
• D. Cystitis

Correct answer: D

Rationale: The correct answer is D, Cystitis. Cystitis specifically refers to the inflammation of the bladder lining. Choice A, Incontinence, refers to the loss of bladder control and is not related to inflammation. Choice B, Pyelonephritis, is the inflammation of the kidney and renal pelvis, not the bladder lining. Choice C, Urinary calculi, refers to the formation of stones in the urinary tract and is not related to bladder inflammation.

5. When starting on oral contraceptives, what should the nurse include in the education regarding the timing of the medication?

• A. Oral contraceptives should be taken at the same time each day to maintain stable hormone levels and prevent pregnancy.
• B. Oral contraceptives can be taken at any time of day, as long as the schedule is consistent.
• C. Oral contraceptives should be taken in the morning to avoid nighttime side effects.
• D. Oral contraceptives are effective immediately upon starting, regardless of timing.

Correct answer: A

Rationale: When educating a patient starting on oral contraceptives, it is essential to stress the importance of taking the medication at the same time each day. This ensures stable hormone levels, improving the effectiveness of the contraceptives in preventing pregnancy. Choice B is incorrect because consistency in timing is crucial for maintaining hormone levels. Choice C is incorrect as there is no specific requirement to take oral contraceptives in the morning to avoid side effects. Choice D is incorrect as oral contraceptives may take some time to become fully effective, and consistent timing is important for their efficacy.

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