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. During surgery, the anesthesia personnel notice the client is having a steady rise in end-tidal carbon dioxide level. At this time, the nurse anesthetist begins to assess the client for malignant hyperthermia. The initial (priority) assessment for this disorder may include:

• A. measuring serum potassium levels.
• B. monitoring for muscle rigidity.
• C. evaluating renal function.
• D. checking arterial blood gases.

Correct answer: B

Rationale: The correct answer is B: monitoring for muscle rigidity. Muscle rigidity is a hallmark sign of malignant hyperthermia, a life-threatening condition triggered by certain anesthetics. Monitoring for this sign is critical in the early identification of the condition. Choices A, C, and D are not the initial priority assessments for malignant hyperthermia. Measuring serum potassium levels, evaluating renal function, and checking arterial blood gases are not specific initial assessments for malignant hyperthermia and would not aid in its early identification.

3. What important instruction should the nurse provide regarding the application of testosterone gel in a patient with hypogonadism?

• A. Apply the gel to the chest or upper arms and allow it to dry completely before dressing.
• B. Apply the gel to the face and neck for maximum absorption.
• C. Apply the gel to the genitals for improved results.
• D. Apply the gel to the scalp and back for better results.

Correct answer: A

Rationale: The correct instruction for applying testosterone gel in a patient with hypogonadism is to apply it to the chest or upper arms and allow it to dry completely before dressing. This method helps avoid transfer to others. Applying the gel to the face, neck, or genitals is not recommended as it can lead to unintended exposure to others. Additionally, applying the gel to the scalp and back is not a standard or effective route of administration for testosterone gel. Therefore, choice A is the correct answer as it ensures proper application and safety.

4. A patient has suffered from several infections in the last 6 months and unexplained impaired wound healing. What assessment should the nurse prioritize?

• A. Assess for pain.
• B. Assess for nutritional deficiencies.
• C. Assess genetic tendency for infection.
• D. Assess for edema and decreased hemoglobin.

Correct answer: B

Rationale: In this scenario, the patient's history of multiple infections and impaired wound healing indicates a potential issue with their immune system and overall health. Therefore, the nurse should prioritize assessing for nutritional deficiencies. Proper nutrition is essential for a healthy immune response and wound healing. Assessing for pain (choice A) may be important but addressing the root cause of the recurrent infections and impaired wound healing is crucial. Genetic tendency for infection (choice C) would be a less immediate concern compared to assessing for nutritional deficiencies. Edema and decreased hemoglobin (choice D) are not the most relevant assessments based on the patient's symptoms.

5. A patient with benign prostatic hyperplasia (BPH) is prescribed finasteride (Proscar). What outcome should the nurse expect to observe if the medication is effective?

• A. Increased urinary frequency and urgency
• B. Decreased prostate size
• C. Increased prostate size
• D. Decreased blood pressure

Correct answer: B

Rationale: The correct answer is B: Decreased prostate size. Finasteride is a medication used to reduce the size of the prostate gland in patients with BPH. By decreasing the size of the prostate, symptoms such as urinary frequency and urgency are improved. Choice A is incorrect as the medication aims to decrease, not increase, urinary symptoms. Choice C is incorrect because the goal of finasteride is to reduce, not increase, the prostate size. Choice D is also incorrect as finasteride is not indicated for lowering blood pressure.

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