Nursing Elites

1. A nursing student is learning about the effects of bactericidal agents. How does rifampin (Rifadin) achieve a therapeutic action against both intracellular and extracellular tuberculosis organisms?

• A. It is metabolized in the liver.
• B. It binds to acetylcholine.
• C. It inhibits synthesis of RNA.
• D. It causes phagocytosis.

Correct answer: C

Rationale: Rifampin (Rifadin) achieves a therapeutic action against both intracellular and extracellular tuberculosis organisms by inhibiting the synthesis of RNA. This action interferes with bacterial RNA synthesis, leading to the suppression of protein synthesis in the bacteria, ultimately causing their death. Option A is incorrect because rifampin is primarily metabolized in the liver, but this is not how it exerts its bactericidal effects. Option B is incorrect as rifampin does not bind to acetylcholine. Option D is also incorrect as rifampin does not cause phagocytosis.

2. When a Tae Kwon Do (TKD) master applies downward pressure just above the elbow joint on an attacker who immediately collapses to the ground, which reflex is applicable to this example?

• A. Golgi tendon reflex
• B. Myotatic reflex
• C. Withdrawal reflex
• D. Crossed-extensor reflex

Correct answer: A

Rationale: The Golgi tendon reflex is the correct answer. This reflex protects the muscle and tendons from excessive force by causing the muscle to relax. In this scenario, the downward pressure applied just above the elbow joint triggers the Golgi tendon reflex, resulting in the attacker's collapse. The other options are incorrect: - The myotatic reflex (also known as the stretch reflex) is responsible for contracting a muscle in response to its stretch, not relaxing it. - The withdrawal reflex is a spinal reflex that moves a body part away from a painful stimulus, not directly related to the scenario described. - The crossed-extensor reflex is a reflex that occurs on the opposite side of the body in response to a withdrawal reflex, which is not the case in this situation.

3. A patient has been diagnosed with chronic renal failure. Which of the following agents will assist in raising the patient's hemoglobin levels?

• A. Epoetin alfa (Epogen, Procrit)
• B. Pentoxifylline (Pentoxil)
• C. Estazolam (ProSom)
• D. Dextromethorphan hydrobromide

Correct answer: A

Rationale: The correct answer is A: Epoetin alfa (Epogen, Procrit). Epoetin alfa is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in patients with chronic renal failure. By increasing red blood cell production, epoetin alfa helps raise hemoglobin levels in these patients. Pentoxifylline (Choice B) is not indicated for raising hemoglobin levels in chronic renal failure patients; it is a peripheral vasodilator used to improve blood flow. Estazolam (Choice C) is a benzodiazepine used for treating insomnia and has no role in raising hemoglobin levels. Dextromethorphan hydrobromide (Choice D) is a cough suppressant and is not used to raise hemoglobin levels in patients with chronic renal failure.

4. A client is brought to the emergency department after a motor vehicle accident in which she suffered a spinal cord injury at the level of C5. Which of the following assessments should be the priority?

• A. Monitoring urinary output
• B. Monitoring heart rate and rhythm
• C. Monitoring respiratory rate
• D. Monitoring the client's pain levels

Correct answer: B

Rationale: The correct answer is monitoring heart rate and rhythm. With a C5 spinal cord injury, monitoring heart rate and rhythm is crucial as it can impact autonomic regulation. This level of injury can affect cardiac function due to the disruption of sympathetic nerve fibers. Monitoring urinary output may be important to assess for urinary retention, but it is not the priority in this scenario. While monitoring respiratory rate is essential in all patients, in this case, cardiovascular stability takes precedence. Pain management is important but is not the priority when assessing a client with a C5 spinal cord injury.

5. A 52-year-old male patient is taking finasteride (Proscar) for benign prostatic hyperplasia (BPH). What patient teaching should the nurse provide?

• A. Take the medication with food.
• B. Avoid taking NSAIDs while on this medication.
• C. Avoid driving or operating heavy machinery while taking this medication.
• D. Women who are or may become pregnant should not handle crushed or broken tablets.

Correct answer: D

Rationale: The correct answer is D. Finasteride, used for BPH, can be harmful to a developing male fetus. Therefore, women who are or may become pregnant should not handle crushed or broken tablets to avoid potential absorption through the skin. Choice A is incorrect as finasteride can be taken with or without food. Choice B is incorrect because there is no specific interaction between finasteride and NSAIDs mentioned. Choice C is incorrect as finasteride does not typically cause drowsiness or impair mental alertness.

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