Nursing Elites

1. A patient has acute respiratory failure (ARF). Which of the following would the nurse expect to find?

• A. Alkalosis and hyperventilation
• B. Hypoxemia and hypercapnia
• C. Alkalosis and high potassium
• D. Elevated sodium and acidosis

Correct answer: B

Rationale: In acute respiratory failure, hypoxemia (low blood oxygen) and hypercapnia (high blood carbon dioxide) are commonly observed. Choice A is incorrect because alkalosis (high pH) and hyperventilation are not typically seen in acute respiratory failure. Choice C is incorrect as it mentions alkalosis and high potassium, which are not characteristic of acute respiratory failure. Choice D is also incorrect because elevated sodium and acidosis are not typically associated with acute respiratory failure.

2. What causes secondary brain injury after head trauma?

• A. Brain injury resulting from the body’s response to tissue damage
• B. Brain injury resulting from initial trauma
• C. Injury as a result of medical therapy
• D. Focal areas of bleeding

Correct answer: A

Rationale: The correct answer is A. Secondary brain injury occurs due to the body's response to the initial trauma, which can worsen the effects of the primary injury. This response includes processes like inflammation, increased intracranial pressure, and reduced oxygen delivery to tissues. Choice B is incorrect because it refers to the primary trauma itself, not the secondary injury. Choice C is incorrect as it relates to injury caused by medical interventions rather than the body's response. Choice D is incorrect as it specifically mentions focal areas of bleeding, which is a consequence of trauma rather than the cause of secondary brain injury.

3. How can a colony-stimulating factor affect the patient's erythrocyte count?

• A. It stimulates the growth of red blood cells.
• B. It suppresses T-cell production.
• C. It inhibits protein synthesis.
• D. It stimulates antibody production.

Correct answer: A

Rationale: Colony-stimulating factors are substances that stimulate the production of blood cells in the bone marrow. Erythrocytes are red blood cells, so a colony-stimulating factor would specifically stimulate the growth of red blood cells, leading to an increase in the patient's erythrocyte count. Choice B is incorrect because colony-stimulating factors do not suppress T-cell production. Choice C is incorrect because colony-stimulating factors do not inhibit protein synthesis. Choice D is incorrect because colony-stimulating factors do not stimulate antibody production; they primarily affect the production of blood cells.

4. Which of the following nonpharmacologic treatments is most likely to be a useful and appropriate supplement to pharmacologic analgesia at this point?

• A. Cognitive-behavioral therapy
• B. Cold and heat application
• C. Therapeutic ultrasound
• D. Biofeedback

Correct answer: B

Rationale: The correct answer is B: Cold and heat application. Cold and heat application are commonly used nonpharmacologic methods for managing pain and can complement pharmacologic treatments. Cold packs can help reduce inflammation and numb localized areas, while heat application can increase blood flow and relax muscles. Cognitive-behavioral therapy (A) focuses on changing negative thought patterns and behaviors to manage pain but may not directly supplement pharmacologic analgesia. Therapeutic ultrasound (C) uses sound waves to generate heat within body tissues, which can be therapeutic, but it may not be as directly complementary to pharmacologic analgesia as cold and heat application. Biofeedback (D) involves using electronic devices to help individuals control physiological processes, but its direct role as a supplement to pharmacologic analgesia may be less pronounced compared to cold and heat application.

5. A female patient is concerned about the side effects of oral contraceptives. What should the nurse explain as a common side effect?

• A. Increased energy levels
• B. Decreased libido
• C. Weight gain
• D. Hair loss

Correct answer: C

Rationale: The correct answer is C: Weight gain. Weight gain is a common side effect of oral contraceptives due to hormonal changes. It is essential for healthcare providers to inform patients about this possibility to manage expectations. Choice A, increased energy levels, is not a common side effect of oral contraceptives. Choice B, decreased libido, can be a side effect for some individuals but is not as common as weight gain. Choice D, hair loss, is not typically associated with oral contraceptives. Therefore, it is important for the nurse to address the patient's concerns by discussing the more prevalent side effects like weight gain.

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