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. A 30-year-old man has a history of heart transplant and is receiving long-term steroids to prevent rejection. The patient is due for routine vaccines. Attenuated vaccines are contraindicated in this patient because the antigen is:

• A. live and can cause infection.
• B. mutated and infectious.
• C. inactive but still infectious.
• D. pathogenic.

Correct answer: A

Rationale: The correct answer is A: live and can cause infection. In patients like the one described with a history of heart transplant and receiving long-term steroids, who are immunocompromised, live attenuated vaccines are contraindicated. Live vaccines contain weakened (attenuated) forms of the virus or bacteria, which can replicate and cause mild infections in healthy individuals but can lead to serious infections in immunocompromised individuals. Choices B, C, and D are incorrect because attenuated vaccines are not mutated, not inactive, and not pathogenic in healthy individuals, respectively.

3. When educating a patient starting on oral contraceptives, what should the nurse include regarding the medication's effectiveness?

• A. Oral contraceptives are 100% effective when taken correctly.
• B. Oral contraceptives are effective immediately after starting.
• C. Oral contraceptives are less effective if taken with antibiotics.
• D. Oral contraceptives are less effective if taken with food.

Correct answer: C

Rationale: The correct answer is C. Oral contraceptives can be less effective when taken with certain antibiotics as they may interfere with the contraceptive's efficacy, potentially leading to decreased effectiveness. Therefore, patients should be advised to use additional contraception methods if they are also taking antibiotics. Choice A is incorrect because while oral contraceptives are highly effective, they are not 100% foolproof. Choice B is incorrect as oral contraceptives may take some time to reach their full effectiveness after starting. Choice D is incorrect since taking oral contraceptives with food does not necessarily impact their effectiveness.

4. What property is found in clients with metastatic cancer?

• A. Tumors that are well encapsulated
• B. Tumors with slow, stable growth
• C. Cells that are genetically stable
• D. Cells invading local tissue and overrunning neighboring cells

Correct answer: D

Rationale: Metastatic cancer is characterized by cells that invade local tissue and overrun neighboring cells. Therefore, the correct answer is D. Choices A, B, and C are incorrect because metastatic cancer is associated with aggressive behavior where cells invade and spread to other parts of the body, rather than being well encapsulated, growing slowly, or being genetically stable.

5. Which of the following are risk factors for hypertension (HTN)?

• A. High sugar, low-fat diet
• B. Increased physical activity
• C. Tobacco use
• D. Low-fat diet

Correct answer: C

Rationale: Tobacco use is a well-established risk factor for hypertension (HTN) as it can lead to increased blood pressure. High sugar intake and low-fat diets, as well as increased physical activity, are not directly associated with hypertension. While low-fat diets are generally recommended for overall health, they are not specifically linked to hypertension risk.

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