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. Which of the following types of vitamin or mineral deficiency can cause megaloblastic anemia and is associated with lower extremity paresthesias?

• A. Vitamin B12
• B. Folate
• C. Iron
• D. Vitamin K

Correct answer: A

Rationale: The correct answer is Vitamin B12. Vitamin B12 deficiency can lead to megaloblastic anemia and neurological symptoms, including lower extremity paresthesias. Folate deficiency can also cause megaloblastic anemia but typically does not present with neurological symptoms. Iron deficiency leads to microcytic anemia, not megaloblastic anemia. Vitamin K deficiency is associated with coagulation abnormalities, not megaloblastic anemia.

3. What key contraindication should the nurse emphasize to a patient prescribed sildenafil (Viagra) for erectile dysfunction?

• A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension.
• B. Sildenafil should not be taken with food as it can reduce its effectiveness.
• C. Sildenafil is contraindicated in patients with a history of hypertension.
• D. Sildenafil should not be taken with grapefruit juice as it can lead to dangerous side effects.

Correct answer: A

Rationale: The correct answer is A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because there is no specific contraindication for taking sildenafil with food, having a history of hypertension, or taking it with grapefruit juice. The main concern is the concurrent use of nitrates with sildenafil.

4. A 10-year-old male is stung by a bee while playing in the yard. He begins itching and develops pain, swelling, redness, and respiratory difficulties. He is suffering from:

• A. Immunodeficiency
• B. Autoimmunity
• C. Anaphylaxis
• D. Tissue-specific hypersensitivity

Correct answer: C

Rationale: The correct answer is C: Anaphylaxis. Anaphylaxis is a severe, immediate allergic reaction mediated by IgE. In this scenario, the symptoms of itching, pain, swelling, redness, and respiratory difficulties following a bee sting are indicative of anaphylaxis. Choice A, Immunodeficiency, refers to a weakened immune system's inability to protect the body from infections and diseases, which is not the case here. Choice B, Autoimmunity, involves the immune system attacking healthy cells and tissues by mistake, which is not the mechanism at play in anaphylaxis. Choice D, Tissue-specific hypersensitivity, does not accurately describe the immediate, systemic reaction seen in anaphylaxis.

5. What is a characteristic of coronary artery disease (CAD)?

• A. The build-up of infectious by-products in the lymph nodes
• B. Insufficient delivery of oxygenated blood to the myocardium
• C. Insufficient delivery of carbon dioxide to the lungs
• D. The build-up of bile in the stomach and gallbladder

Correct answer: B

Rationale: The correct characteristic of coronary artery disease (CAD) is the insufficient delivery of oxygenated blood to the myocardium. CAD is a condition where the coronary arteries become narrowed or blocked, leading to reduced blood flow to the heart muscle. This lack of oxygenated blood can result in chest pain, known as angina, and if a coronary artery becomes completely blocked, it can cause a heart attack. Choices A, C, and D are incorrect. Choice A refers to an issue related to the lymphatic system, choice C is about gas exchange in the lungs, and choice D describes a problem with bile accumulation in the digestive system, none of which are characteristics of CAD.

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