Nursing Elites

1. A patient with a diagnosis of renal failure is being treated with epoetin alfa (Epogen). Frequent assessment of which of the following laboratory values should be prioritized before and during treatment?

• A. AST
• B. C-reactive protein
• C. CBC
• D. ALT

Correct answer: A

Rationale: The correct answer is AST. Epoetin alfa is a medication used to treat anemia associated with chronic renal failure. During treatment with epoetin alfa, it is crucial to monitor AST levels as this medication can potentially lead to liver toxicity. Assessing AST levels before and throughout treatment helps in early detection of any liver abnormalities. C-reactive protein is not specifically related to the use of epoetin alfa in renal failure. While CBC (Complete Blood Count) monitoring is essential during treatment with epoetin alfa to evaluate the response to therapy, prioritizing AST assessment is more critical due to the potential for liver toxicity. ALT monitoring is also important but AST is prioritized in this scenario.

2. A patient is taking a statin for hyperlipidemia. What important instruction should the nurse provide to the patient?

• A. Take the medication at night to avoid muscle pain.
• B. Take the medication in the morning to ensure it works throughout the day.
• C. Avoid consuming alcohol while taking this medication.
• D. Take the medication with a high-fat meal to increase absorption.

Correct answer: A

Rationale: The correct answer is to instruct the patient to take the medication at night to avoid muscle pain. Statins are known to potentially cause muscle pain or weakness; taking the medication at night can help reduce the incidence of these side effects. Option B is incorrect because the timing of statin administration is not related to its effectiveness throughout the day. Option C is a general precaution when taking medications but not the most important instruction specific to statins. Option D is incorrect as taking the medication with a high-fat meal can actually decrease its absorption.

3. What is a common cause of a pulmonary embolism?

• A. An autoimmune disorder
• B. A venous blood clot from the lower extremity
• C. An increase in intracranial pressure
• D. Hypotension

Correct answer: B

Rationale: A pulmonary embolism is commonly caused by a blood clot that originates in the venous system of the lower extremity and travels to the lungs, blocking blood flow. This clot is known as a venous thromboembolism. An autoimmune disorder (Choice A) is not typically associated with pulmonary embolism. Intracranial pressure (Choice C) refers to pressure inside the skull and is unrelated to pulmonary embolism. Hypotension (Choice D) is low blood pressure and is not a common cause of pulmonary embolism.

4. A 1-year-old child will receive her scheduled MMR vaccination shortly. The nurse should teach the child's parents that she may develop what possible adverse effect related to the administration of this vaccine?

• A. Cough and fever
• B. Pallor and listlessness
• C. Serum sickness
• D. Nausea and vomiting

Correct answer: A

Rationale: The correct answer is A: Cough and fever. After receiving the MMR vaccine, some children may experience mild adverse effects such as a low-grade fever and a mild cough. These symptoms are normal reactions to the vaccine and indicate that the child's immune system is responding appropriately. Choices B, C, and D are incorrect because pallor and listlessness, serum sickness, nausea, and vomiting are not common adverse effects associated with the MMR vaccine in children.

5. Which of the following chronic inflammatory skin disorders is characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation?

• A. Psoriasis
• B. Melanoma
• C. Atopic dermatitis
• D. Urticaria

Correct answer: A

Rationale: Psoriasis is the correct answer. Psoriasis is a chronic inflammatory skin disorder characterized by angiogenesis, immune cell activation (particularly T cells), and keratinocyte proliferation. Choice B, Melanoma, is a type of skin cancer involving melanocytes, not characterized by the features mentioned. Choice C, Atopic dermatitis, is a different inflammatory skin condition associated with pruritus and eczematous lesions, not primarily characterized by angiogenesis. Choice D, Urticaria, is a skin condition characterized by hives and wheals due to histamine release, not typically involving the features mentioned in the question.

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