Nursing Elites

1. A staff member asks what leukocytosis means. How should the nurse respond? Leukocytosis can be defined as:

• A. A normal leukocyte count
• B. A high leukocyte count
• C. A low leukocyte count
• D. Another term for leukopenia

Correct answer: B

Rationale: Leukocytosis refers to an abnormally high leukocyte count. This condition is characterized by an elevated number of white blood cells in the bloodstream. Choice A is incorrect because leukocytosis does not refer to a normal leukocyte count. Choice C is incorrect as leukocytosis is not related to a low leukocyte count. Choice D is incorrect as leukopenia is the opposite of leukocytosis, indicating a low white blood cell count.

2. A college student has a TB test prior to starting the semester. The tuberculin test site is noted with a reddened, raised area. What condition will the student be diagnosed with if the chest radiograph is negative?

• A. Transmission
• B. Primary infection
• C. Latent tuberculosis
• D. Active tuberculosis

Correct answer: C

Rationale: If the chest radiograph is negative despite a positive tuberculin skin test, the student will be diagnosed with latent tuberculosis infection. Latent tuberculosis means the student has the TB bacteria in their body but does not feel sick and cannot spread the disease. Choice A, 'Transmission,' is incorrect as it refers to the spread of TB from person to person. Choice B, 'Primary infection,' is incorrect because primary infection occurs when a person is first infected with the TB bacteria. Choice D, 'Active tuberculosis,' is incorrect as this refers to the active form of the disease where the person feels sick and can spread TB to others.

3. A client presents to the emergency department with lower right quadrant abdominal pain, fever, nausea, and occasional diarrhea. After palpating the abdomen, the client displays tenderness. What would the nurse anticipate the client to be experiencing?

• A. Pseudomembranous colitis
• B. Peptic ulcer disease
• C. Appendicitis
• D. Esophageal cancer

Correct answer: C

Rationale: The correct answer is C: Appendicitis. The symptoms described - lower right quadrant abdominal pain, fever, nausea, diarrhea, and tenderness upon palpation - are classic signs of appendicitis. Appendicitis is an inflammatory condition of the appendix that often presents with these symptoms and requires immediate medical attention. Choice A, Pseudomembranous colitis, typically presents with watery diarrhea and is associated with antibiotic use. Choice B, Peptic ulcer disease, commonly presents with epigastric pain related to meals and can be accompanied by nausea or vomiting, but it does not typically cause right lower quadrant pain. Choice D, Esophageal cancer, usually presents with symptoms related to swallowing difficulties, weight loss, and sometimes chest pain, but it is not associated with the symptoms described in the scenario.

4. What causes hepatic encephalopathy?

• A. A brain infection
• B. Increased ammonia levels in the bloodstream
• C. Decreased albumin blood levels
• D. Untreated chronic bronchitis

Correct answer: B

Rationale: Hepatic encephalopathy is caused by increased ammonia levels in the bloodstream. Ammonia, a byproduct of protein metabolism normally processed by the liver, accumulates in the bloodstream when the liver is unable to function properly. This excess ammonia affects brain function, leading to symptoms of hepatic encephalopathy. Choices A, C, and D are incorrect because they do not directly relate to the pathophysiology of hepatic encephalopathy.

5. A 30-year-old woman is taking an oral contraceptive and is concerned about the potential side effects. What should the nurse include in the patient education?

• A. Oral contraceptives can cause weight loss and increased energy levels.
• B. Oral contraceptives can cause increased appetite and weight gain.
• C. Oral contraceptives can cause headaches and breast tenderness.
• D. Oral contraceptives have no side effects.

Correct answer: C

Rationale: The correct answer is C: 'Oral contraceptives can cause headaches and breast tenderness.' It is essential for the nurse to educate the patient about common side effects of oral contraceptives, such as headaches and breast tenderness. Choices A, B, and D are incorrect. Weight loss and increased energy levels (Choice A) are not common side effects of oral contraceptives. Similarly, increased appetite and weight gain (Choice B) are not typical side effects. Finally, stating that oral contraceptives have no side effects (Choice D) is inaccurate as they can have various side effects, albeit usually mild and manageable.

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