Nursing Elites

1. A patient is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the main rationale for administering these medications together?

• A. They improve treatment adherence.
• B. They reduce the duration of illness.
• C. They exhibit synergistic antiviral effects.
• D. They prevent opportunistic infections.

Correct answer: C

Rationale: The main rationale for administering a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor is that they exhibit synergistic antiviral effects when used together. This combination enhances their antiviral activity against HIV by targeting different steps in the viral replication cycle. Choice A is incorrect because the rationale for combining these medications is based on their antiviral effects, not treatment adherence. Choice B is incorrect because the primary purpose of combination therapy is not to reduce the duration of illness but to improve treatment efficacy. Choice D is incorrect as the main focus of this combination is not on preventing opportunistic infections but on directly targeting the HIV virus.

2. Which of the following hormones do the kidneys secrete to increase red blood cell production?

• A. Erythropoietin
• B. Insulin and glycogen
• C. Testosterone
• D. Thyroid stimulating hormone

Correct answer: A

Rationale: The correct answer is A: Erythropoietin. The kidneys produce erythropoietin to stimulate the production of red blood cells. Insulin and glycogen are not hormones secreted by the kidneys; insulin is produced by the pancreas, and glycogen is a stored form of glucose. Testosterone is a hormone primarily produced by the testes in males and to a lesser extent in females. Thyroid stimulating hormone is produced by the pituitary gland to regulate thyroid function, not red blood cell production.

3. When planning care for a cardiac patient, the nurse knows that in response to an increased workload, cardiac myocardial cells will:

• A. Increase in size
• B. Decrease in length
• C. Increase in excitability
• D. Increase in number

Correct answer: A

Rationale: The correct answer is A: Increase in size. Cardiac hypertrophy occurs when myocardial cells increase in size to compensate for an increased workload. This adaptation allows the heart to pump more effectively. Choice B, Decrease in length, is incorrect as cardiac cells do not decrease in length in response to increased workload. Choice C, Increase in excitability, is incorrect as increased workload does not lead to an increase in excitability of cardiac cells. Choice D, Increase in number, is incorrect as cardiac cells do not increase in number but rather increase in size to handle the increased workload.

4. The parents of a 4-year-old girl have sought care because their daughter has admitted to chewing and swallowing imported toy figurines that have been determined to be made of lead. Which of the following blood tests should the care team prioritize?

• A. White blood cell levels with differential
• B. Red blood cell levels and morphology
• C. Urea and creatinine levels
• D. Liver function panel

Correct answer: B

Rationale: The correct answer is B: Red blood cell levels and morphology. Lead poisoning primarily affects red blood cells, causing anemia. Therefore, the priority test would be to assess red blood cell levels and morphology. Choice A (White blood cell levels with differential) is incorrect as lead poisoning does not primarily affect white blood cells. Choice C (Urea and creatinine levels) is unrelated to lead poisoning and not a priority in this scenario. Choice D (Liver function panel) is also not the priority as lead poisoning's primary impact is on the red blood cells, not the liver.

5. A nurse on a postsurgical unit is providing care for a 76-year-old female client who is two days post-hemiarthroplasty (hip replacement) and who states that her pain has been out of control for the last several hours, though she is not exhibiting signs of pain. Which guideline should the nurse use for short-term and long-term treatment of the client's pain?

• A. Pain is what the client says it is, even if she is not exhibiting outward signs.
• B. Pain should be treated only when it is associated with observable symptoms.
• C. Long-term opioid use is generally safe for elderly clients in a hospital setting.
• D. The client's pain should be reassessed after every dose of pain medication.

Correct answer: A

Rationale: Pain is a subjective experience, and the client's report of pain should be taken seriously even if there are no outward signs. Choice B is incorrect because pain can be present without observable symptoms, and waiting for observable signs may delay appropriate pain management. Choice C is incorrect because the safety of long-term opioid use in elderly clients is a complex issue and should be carefully evaluated due to the risk of adverse effects. Choice D is incorrect because while pain reassessment is important, it should not be limited to just after medication administration but should occur regularly to ensure adequate pain control.

Similar Questions