Nursing Elites

1. A student nurse was asked which of the following best describes dementia. Which of the following best describes the condition?

• A. Memory loss as a natural consequence of aging
• B. Difficulty coping with physical and psychological changes
• C. Severe cognitive impairment that occurs rapidly
• D. Loss of cognitive abilities, impairing the ability to perform activities of daily living

Correct answer: D

Rationale: The correct answer is D. Dementia is characterized by a loss of cognitive abilities that impairs the individual's capacity to perform activities of daily living. Choice A is incorrect because dementia is not simply memory loss related to aging but involves broader cognitive deficits. Choice B is incorrect as it does not capture the comprehensive cognitive decline seen in dementia. Choice C is incorrect as dementia typically progresses gradually rather than rapidly, and it is not solely about severe cognitive impairment but also impacts daily functioning.

2. During an acute asthma exacerbation, what is the priority nursing intervention for a client with asthma?

• A. Administer corticosteroids to reduce airway inflammation.
• B. Position the client in high-Fowler's position.
• C. Administer short-acting beta-agonists (SABAs) as prescribed.
• D. Obtain a peak flow reading to assess the severity of the exacerbation.

Correct answer: C

Rationale: The priority nursing intervention during an acute asthma exacerbation is to administer short-acting beta-agonists (SABAs) as prescribed. SABAs help in quickly relieving bronchospasm and are considered the first-line treatment for acute exacerbations. Administering corticosteroids, positioning the client, and obtaining a peak flow reading are important interventions but come after administering SABAs in the management of acute asthma exacerbation.

3. 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.

4. After ingestion of cysts, how long does it take for the symptoms of giardiasis to develop?

• A. 12 to 24 hours
• B. 3 to 5 days
• C. 1 to 2 weeks
• D. 2 to 3 months

Correct answer: B

Rationale: Giardiasis symptoms typically develop 3 to 5 days after ingestion of the cysts. This timeframe aligns with the incubation period of the Giardia parasite. Choice A (12 to 24 hours) is too short for giardiasis to manifest. Choice C (1 to 2 weeks) and choice D (2 to 3 months) represent durations that are not consistent with the usual onset of symptoms in giardiasis.

5. What long-term risks should the nurse discuss with a patient starting on hormone replacement therapy (HRT)?

• A. HRT is associated with increased risks of cardiovascular events and breast cancer, so these risks should be discussed with the patient.
• B. HRT can improve mood and energy levels, but it also increases the risk of osteoporosis.
• C. HRT can increase the risk of venous thromboembolism, so patients should undergo regular screening.
• D. HRT decreases the risk of fractures, but it also increases the risk of developing diabetes.

Correct answer: A

Rationale: The correct answer is A. When starting on hormone replacement therapy (HRT), the nurse should discuss the increased risks of cardiovascular events and breast cancer with the patient. These risks are important to consider to make an informed decision. Choice B is incorrect as HRT does not increase the risk of osteoporosis; in fact, it may help prevent it. Choice C is incorrect as while HRT can increase the risk of venous thromboembolism, regular screening is not the primary focus for discussion. Choice D is incorrect as HRT does not decrease the risk of fractures and is not primarily associated with an increased risk of developing diabetes.

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