Nursing Elites

1. What is the major effect of filgrastim (Neupogen) in a patient with chronic renal failure?

• A. Decreases neutropenia related to chemotherapy
• B. Decreases white blood cells related to infection
• C. Decreases growth of blood vessels due to ischemia
• D. Decreases platelet count related to bleeding

Correct answer: A

Rationale: The major effect of filgrastim (Neupogen) is to stimulate the production of neutrophils, thereby decreasing neutropenia in patients undergoing chemotherapy. This medication helps the bone marrow produce more white blood cells, specifically neutrophils, to reduce the risk of infections associated with low neutrophil counts. Choices B, C, and D are incorrect because filgrastim does not decrease white blood cells related to infection, growth of blood vessels, or platelet count related to bleeding.

2. A healthcare provider is explaining to a patient the difference between primary and secondary immunodeficiency disorders and explains that secondary immunodeficiencies (select ONE that does not apply):

• A. May develop after viral infections
• B. Develop before birth
• C. May develop following immunosuppressive therapies
• D. Are caused by superimposed conditions

Correct answer: B

Rationale: The correct statements about secondary immunodeficiencies are that they may develop after viral infections, following immunosuppressive therapies, and are caused by superimposed conditions. Choice B ('Develop before birth') is incorrect because secondary immunodeficiencies do not develop before birth. They are acquired later in life. Therefore, the correct answers are A, C, and D.

3. A patient is hospitalized with active tuberculosis. The patient is receiving antitubercular drug therapy and is not responding to the medications. What do you suspect the patient is suffering from?

• A. Human immunodeficiency virus
• B. Drug-resistant tuberculosis
• C. Methicillin-resistant Staphylococcus aureus
• D. Vancomycin-resistant Staphylococcus aureus

Correct answer: B

Rationale: When a patient with active tuberculosis is not responding to antitubercular drug therapy, drug-resistant tuberculosis should be suspected. Drug-resistant tuberculosis occurs when the bacteria causing tuberculosis become resistant to the medications being used. Choices A, C, and D are incorrect because the scenario described does not align with HIV infection, methicillin-resistant Staphylococcus aureus, or vancomycin-resistant Staphylococcus aureus.

4. An immunology nurse is caring for a patient. While planning care, which principle will the nurse remember? The primary role of IgA1 is to prevent infections in the:

• A. Blood
• B. Kidneys
• C. Lungs
• D. Mucous membranes

Correct answer: A

Rationale: The correct answer is A: Blood. IgA1 is mainly found in the blood and plays a crucial role in preventing infections by neutralizing pathogens. While IgA1 can be present in other body areas, its primary function is associated with preventing infections in the blood. Choices B, C, and D are incorrect as IgA1 is not primarily associated with the kidneys, lungs, or mucous membranes.

5. A patient is starting on atorvastatin (Lipitor) for hyperlipidemia. What important instruction should the nurse provide?

• A. Take the medication at night to reduce the risk of muscle pain.
• B. Avoid consuming grapefruit juice while taking this medication.
• C. Take the medication in the morning with breakfast.
• D. Avoid taking the medication with alcohol to reduce the risk of liver damage.

Correct answer: A

Rationale: The correct answer is A. Atorvastatin should be taken at night to reduce the risk of muscle pain and other side effects. Taking it at night aligns with the body's natural rhythm of cholesterol production, optimizing its effectiveness. Choice B is incorrect because grapefruit juice can increase the risk of side effects by affecting the metabolism of atorvastatin. Choice C is incorrect as taking atorvastatin in the morning does not maximize its effectiveness. Choice D is incorrect because alcohol consumption can increase the risk of liver damage when combined with atorvastatin.

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