Nursing Elites

1. A patient has been diagnosed with cytomegalovirus (CMV). Which of the following drugs would be ineffective in the treatment of this disease?

• A. Ribavirin (Rebetol)
• B. Ganciclovir (Cytovene) IV
• C. Foscarnet (Foscavir) IV
• D. Valganciclovir hydrochloride (Valcyte)

Correct answer: A

Rationale: The correct answer is A, Ribavirin (Rebetol). Ribavirin is not effective against CMV. Choice B, Ganciclovir (Cytovene) IV, is a common treatment for CMV as it inhibits viral DNA synthesis. Choice C, Foscarnet (Foscavir) IV, is also used for CMV infections by blocking viral DNA polymerase. Choice D, Valganciclovir hydrochloride (Valcyte), is a prodrug of Ganciclovir and is effective against CMV. Therefore, Ribavirin is the drug that would be ineffective in treating CMV.

2. A nurse is providing education to a patient starting hormone replacement therapy (HRT) for menopausal symptoms. What should the nurse emphasize regarding the long-term risks associated with HRT?

• A. HRT may increase the risk of cardiovascular events, including heart attack and stroke.
• B. HRT may decrease the risk of osteoporosis.
• C. HRT may improve mood and energy levels.
• D. HRT may decrease the risk of breast cancer.

Correct answer: A

Rationale: HRT is associated with an increased risk of cardiovascular events, including heart attack and stroke, particularly with long-term use.

3. A client presents to the emergency department with complaints of chest pain and shortness of breath. The client's ECG shows ST-segment elevation. What is the priority nursing intervention?

• A. Administer aspirin as prescribed.
• B. Prepare the client for emergent coronary angiography.
• C. Administer oxygen therapy.
• D. Initiate CPR.

Correct answer: B

Rationale: In a client presenting with chest pain, shortness of breath, and ST-segment elevation on ECG, the priority nursing intervention is to prepare the client for emergent coronary angiography. This procedure is crucial in diagnosing and treating acute myocardial infarction promptly. Administering aspirin (Choice A) is important but not the priority over emergent coronary angiography. Administering oxygen therapy (Choice C) is supportive but does not address the underlying cause of the ST-segment elevation. Initiating CPR (Choice D) is not the priority in this scenario as the client is stable and conscious.

4. Which of the following wounds is most likely to heal by secondary intention?

• A. A finger laceration received while cutting onions
• B. A stage IV pressure ulcer that developed in a nursing home
• C. A needlestick injury received while administering parenteral medication
• D. An incision from an open appendectomy

Correct answer: B

Rationale: A stage IV pressure ulcer is a deep wound involving tissue loss that typically heals by secondary intention. This process involves the wound healing from the bottom up with granulation tissue and often results in significant scarring. Choice A, a finger laceration, would generally heal by primary intention due to its clean edges and minimal tissue loss. Choice C, a needlestick injury, is likely to be sutured and heal by primary intention since it is a small, clean wound. Choice D, an incision from an open appendectomy, is usually closed with sutures and heals by primary intention as well.

5. What specific instructions should the nurse provide for a patient starting on alendronate (Fosamax) for osteoporosis to ensure proper administration?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because alendronate should not be taken with milk, as it can interfere with its absorption. Choice C is incorrect as there is no specific instruction to take alendronate at bedtime. Choice D is incorrect because alendronate should be taken on an empty stomach, not with food, to enhance absorption.

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