Nursing Elites

1. In a patient with renal failure secondary to an overdose of a nephrotoxic drug, which assessment findings would the nurse recognize as being most suggestive of impaired erythropoiesis?

• A. Frequent infections and low neutrophil levels
• B. Fatigue and increased heart rate
• C. Agitation and changes in cognition
• D. Increased blood pressure and peripheral edema

Correct answer: A

Rationale: Impaired erythropoiesis refers to a decreased production of red blood cells. This can lead to anemia, resulting in symptoms like fatigue and increased heart rate (Choice B). However, the question specifically asks about assessment findings suggestive of impaired erythropoiesis. In this context, frequent infections and low neutrophil levels (Choice A) are more directly related to impaired erythropoiesis due to the impact of anemia on the immune system. Frequent infections are common in anemia due to a compromised immune response, and low neutrophil levels can be seen in conditions of impaired erythropoiesis. Agitation and changes in cognition (Choice C) are more indicative of neurological issues, while increased blood pressure and peripheral edema (Choice D) are commonly associated with renal failure but not specifically related to impaired erythropoiesis.

2. When communicating with a client who has cognitive impairment, which of the following will Nurse Dory use?

• A. Complete explanations with multiple details
• B. Pictures or gestures instead of words
• C. Stimulating words and phrases to capture the client’s attention
• D. Short words and simple sentences

Correct answer: D

Rationale: Nurse Dory will use short words and simple sentences when communicating with a client who has cognitive impairment. This approach is effective because it helps improve understanding and comprehension for individuals with cognitive challenges. Choice A is incorrect because complete explanations with multiple details may overwhelm or confuse clients with cognitive impairment. Choice B is not the most effective option as using pictures or gestures instead of words may not always be practical or necessary. Choice C is also not ideal as stimulating words and phrases may cause distraction rather than enhance communication for clients with cognitive impairment.

3. What symptoms would the nurse expect to see in a client with chronic obstructive pulmonary disease (COPD)?

• A. Dyspnea on exertion
• B. Normal lung sounds
• C. Normal arterial blood gases
• D. Onset of the disease during young adulthood

Correct answer: A

Rationale: The correct answer is A: Dyspnea on exertion. COPD typically manifests with symptoms like dyspnea on exertion due to impaired lung function. This symptom is a result of the airways being obstructed and the lungs not being able to expel air effectively. Choices B and C are incorrect because in COPD, abnormal lung sounds such as wheezing, crackles, or diminished breath sounds are often heard upon auscultation, and arterial blood gases are usually abnormal, showing low oxygen levels and high carbon dioxide levels. Choice D is incorrect as COPD is more commonly diagnosed in individuals over 40 who have a history of smoking or exposure to lung irritants.

4. When preparing to administer parenteral acyclovir (Zovirax) to an 80-year-old patient with chronic renal failure and herpes simplex, what would the nurse expect in regard to the dose?

• A. The dose is smaller due to the herpes simplex infection.
• B. The dose is smaller based on the patient's kidney function.
• C. The dose is higher in treating genital herpes.
• D. The dose is higher if the creatinine clearance is above 4.0 mg/dL.

Correct answer: B

Rationale: In patients with chronic renal failure, especially in older adults, dosages of medications excreted renally need to be adjusted based on kidney function. Acyclovir is primarily eliminated by the kidneys, so in a patient with chronic renal failure, the dose would need to be smaller to prevent drug accumulation and toxicity. Choice A is incorrect because the dose adjustment is more related to the patient's kidney function than the presence of herpes simplex. Choice C is incorrect because the type of herpes infection does not determine the dose adjustment for acyclovir. Choice D is incorrect as the creatinine clearance is a more accurate measure of kidney function compared to creatinine levels.

5. A woman with severe visual and auditory deficits is able to identify individuals by running her fingers lightly over her face. Which source is most likely to provide the input that allows for the woman's unique ability?

• A. Special somatic afferent fibers
• B. General somatic afferents
• C. Special visceral afferent cells
• D. General visceral afferent neurons

Correct answer: C

Rationale: The correct answer is C, special visceral afferent cells. These cells are responsible for functions like taste and smell. In individuals with severe visual and auditory deficits, their other sensory abilities, such as touch, can be heightened. Special somatic afferent fibers (choice A) are involved in sensations like touch and vibration from the skin and muscles, but they are not specific to the face. General somatic afferents (choice B) transmit sensory information from the skin, muscles, and joints, but they are not specialized for the unique ability described. General visceral afferent neurons (choice D) are responsible for transmitting sensory information from internal organs, not relevant to the woman's ability to identify individuals through touch on her face.

Similar Questions