Nursing Elites

1. A patient is receiving epoetin alfa (Epogen) for anemia. Which of the following adjunctive therapies is imperative with epoetin alfa?

• A. Potassium supplements
• B. Sodium restriction
• C. Iron supplement
• D. Renal dialysis

Correct answer: C

Rationale: The correct answer is C: Iron supplement. When a patient is receiving epoetin alfa for anemia, it is imperative to provide iron supplementation as epoetin alfa works by stimulating the production of red blood cells, which require iron for hemoglobin synthesis. Therefore, iron supplementation is crucial to support the increased erythropoiesis. Choices A, B, and D are incorrect because potassium supplements, sodium restriction, and renal dialysis are not typically indicated as adjunctive therapies with epoetin alfa for anemia.

2. A 35-year-old male has enlarged lymph nodes in the neck and a mediastinal mass. He was diagnosed with Hodgkin lymphoma. Which of the following abnormal cells would the nurse expect to find with this disease?

• A. Merkel cell
• B. Schwann cell
• C. Reed-Sternberg cell
• D. Kupffer cell

Correct answer: C

Rationale: Reed-Sternberg cells are characteristic of Hodgkin lymphoma. These large abnormal cells have a bi-lobed or multi-lobed nucleus and are essential for diagnosing Hodgkin lymphoma through histological examination. Merkel cells are associated with Merkel cell carcinoma, Schwann cells are related to nerve sheaths, and Kupffer cells are liver macrophages. Therefore, choices A, B, and D are incorrect for Hodgkin lymphoma.

3. How are antibodies produced?

• A. B cells
• B. T cells
• C. Helper cells
• D. Memory cells

Correct answer: A

Rationale: Antibodies are produced by B cells. B cells are specialized white blood cells that generate antibodies as part of the immune response. B cells differentiate into plasma cells that secrete antibodies. T cells play a role in cell-mediated immunity, not antibody production. Helper cells, or helper T cells, assist in activating B cells but do not directly produce antibodies. Memory cells store information about previous infections but do not actively produce antibodies.

4. A 70-year-old patient is seen in the family practice clinic. Which of the following vaccines should be administered to prevent shingles?

• A. Zoster vaccine
• B. Haemophilus influenzae Type b (Hib) vaccine
• C. Human papillomavirus (HPV) vaccine
• D. Pneumococcal polyvalent vaccine

Correct answer: A

Rationale: The correct answer is A: Zoster vaccine. The Zoster vaccine is recommended for the prevention of shingles in individuals aged 50 years and older. Shingles is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox. The vaccine helps reduce the risk of developing shingles and decreases the severity and duration of the illness if it occurs. Choices B, C, and D are incorrect: Haemophilus influenzae Type b (Hib) vaccine is used to prevent infections caused by Haemophilus influenzae type b, Human papillomavirus (HPV) vaccine is used to prevent HPV infections that can lead to cervical cancer and other cancers, and Pneumococcal polyvalent vaccine is used to protect against infections caused by the bacterium Streptococcus pneumoniae.

5. Abrupt withdrawal or discontinuation of prednisone can cause:

• A. adrenal crisis.
• B. hypercortisolism.
• C. ACTH stimulation.
• D. thyroid crisis.

Correct answer: A

Rationale: The correct answer is A: adrenal crisis. Abrupt discontinuation of prednisone can lead to adrenal insufficiency, resulting in adrenal crisis. Prednisone is a corticosteroid that suppresses the adrenal glands' ability to produce cortisol. Abrupt withdrawal can cause a sudden drop in cortisol levels, leading to adrenal crisis with symptoms like fatigue, weakness, abdominal pain, and potentially life-threatening low blood pressure. Choices B, C, and D are incorrect because hypercortisolism refers to excess cortisol levels, ACTH stimulation would not result from prednisone withdrawal, and thyroid crisis is not directly related to corticosteroid discontinuation.

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