Nursing Elites

1. A patient has recently been prescribed Zidovudine (Retrovir). The patient has AIDS. Which of the following side effects should the patient specifically watch out for?

• A. Weakness and SOB
• B. Fever and anemia
• C. Hypertension and SOB
• D. Fever and hypertension

Correct answer: B

Rationale: The correct answer is 'Fever and anemia.' Zidovudine (Retrovir) is known to cause anemia as a side effect due to its impact on the bone marrow. Fever is also a common side effect associated with Zidovudine use. Therefore, the patient should watch out for these specific side effects. Choice A (Weakness and SOB) is incorrect as shortness of breath (SOB) is not a commonly reported side effect of Zidovudine. Choice C (Hypertension and SOB) and Choice D (Fever and hypertension) are unrelated to the known side effects of Zidovudine, making them incorrect.

2. What are the major electrolytes in the extracellular fluid?

• A. potassium and chloride
• B. potassium and phosphate
• C. sodium and chloride
• D. sodium and phosphate

Correct answer: C

Rationale: The correct answer is sodium and chloride. These two electrolytes are the major components of extracellular fluid. Potassium and phosphate (Choice B) are not the major electrolytes in the extracellular fluid. Potassium is primarily an intracellular ion, and phosphate is more abundant in the intracellular fluid and bones. Sodium and phosphate (Choice D) are also not the major electrolytes in the extracellular fluid. Chloride plays a crucial role in maintaining electrolyte balance and is predominantly found in extracellular fluid alongside sodium.

3. One drug can alter the absorption of another drug. One drug increases intestinal motility. Which effect does this have on the second drug?

• A. None; absorption of the second drug is not affected.
• B. The increased gut motility decreases the absorption of the second drug.
• C. The absorption of the second drug cannot be predicted.
• D. Less of the second drug is absorbed.

Correct answer: D

Rationale: When one drug increases intestinal motility, it accelerates the movement of the second drug through the system. Since most oral medications are absorbed in the intestine, the faster transit time decreases the absorption of the second drug. Therefore, less of the second drug is absorbed. Choice A is incorrect because the increased gut motility does affect the absorption of the second drug. Choice C is incorrect as the effect of increased intestinal motility on drug absorption can be predicted based on pharmacokinetic principles. Choice B is incorrect as increased gut motility would not increase but decrease the absorption of the second drug.

4. A patient has been diagnosed with fibromyalgia and COPD. Which of the following tasks should the nurse delegate to a nursing assistant?

• A. Transferring the patient to the shower.
• B. Ambulating the patient for the first time.
• C. Taking the patient's breath sounds.
• D. Educating the patient on monitoring fatigue.

Correct answer: A

Rationale: The correct answer is to delegate the task of transferring the patient to the shower to a nursing assistant. Nursing assistants are trained to assist with transfers safely, making this task appropriate for delegation. Ambulating the patient for the first time involves assessing the patient's mobility and tolerance, which requires more assessment and monitoring by a nurse, especially in a patient with fibromyalgia and COPD. Taking the patient's breath sounds involves assessing the patient's respiratory status, which is a nursing responsibility due to the need for clinical judgment. Educating the patient on monitoring fatigue involves providing vital information and should be done by the nurse to ensure comprehensive understanding and tailored recommendations.

5. The nurse is teaching a community health class for cancer prevention and screening. Which individual has the highest risk for colon cancer?

• A. Client with irritable bowel syndrome
• B. Family history of colon polyps
• C. Client with cirrhosis of the liver
• D. History of colon surgery

Correct answer: B

Rationale: A family history of colon polyps and/or colon cancer is a significant risk factor for developing colon cancer. Individuals with a family history are more likely to develop colon cancer due to genetic predisposition. While other factors like irritable bowel syndrome, cirrhosis of the liver, and history of colon surgery may contribute to an increased risk of colon cancer, having a family history of colon polyps is the highest risk factor. Irritable bowel syndrome does not directly increase the risk of colon cancer. Cirrhosis of the liver is associated with liver cancer rather than colon cancer. A history of colon surgery may reduce the risk of colon cancer in some cases by removing precancerous polyps.

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