Nursing Elites

1. 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.

2. Which of the following birthmarks usually fade or regress as the child gets older?

• A. Hemangiomas
• B. Congenital dermal melanocytosis (i.e., Mongolian spots)
• C. Macular stains
• D. Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains

Correct answer: Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains

Rationale: The correct answer is Hemangiomas, congenital dermal melanocytosis (i.e., Mongolian spots), and macular stains. These three types of birthmarks are known to fade or regress as the child gets older. Hemangiomas are vascular birthmarks that often shrink and disappear over time. Congenital dermal melanocytosis, commonly known as Mongolian spots, usually fade by adolescence. Macular stains, also called salmon patches, tend to lighten and fade as a child grows. The other choices are incorrect because they do not typically fade or regress with age.

3. A 43-year-old man has tested positive for systemic candidiasis, and the care team has decided on IV fluconazole as a first-line treatment. When administering this medication, the nurse should

• A. administer the drug with lactated Ringer's.
• B. infuse the drug no faster than 200 mg/h.
• C. avoid administering the drug through a peripheral IV.
• D. administer prophylactic heparin prior to the fluconazole.

Correct answer: C

Rationale: When administering IV fluconazole, the nurse should avoid administering the drug through a peripheral IV. Fluconazole is known to cause phlebitis and tissue irritation if infused through a peripheral IV line. It is recommended to administer fluconazole through a central venous catheter to reduce the risk of complications. Choices A, B, and D are incorrect as there is no specific recommendation to administer the drug with lactated Ringer's, infuse it at a particular rate, or administer prophylactic heparin prior to fluconazole in this scenario.

4. After studying about fungi, which information indicates a correct understanding of fungi? Fungi causing deep or systemic infections:

• A. Are easily treated with penicillin
• B. Are extremely rare
• C. Never occur with other infections
• D. Are commonly opportunistic

Correct answer: D

Rationale: The correct answer is D: 'Are commonly opportunistic.' Fungi causing deep or systemic infections are commonly opportunistic, particularly in individuals with compromised immune systems. Choice A is incorrect because fungi infections are not easily treated with penicillin. Choice B is incorrect as deep or systemic fungal infections are not extremely rare. Choice C is incorrect as fungal infections can co-occur with other infections.

5. What key contraindication should the nurse emphasize to a patient prescribed sildenafil (Viagra) for erectile dysfunction?

• A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension.
• B. Sildenafil should not be taken with food as it can reduce its effectiveness.
• C. Sildenafil is contraindicated in patients with a history of hypertension.
• D. Sildenafil should not be taken with grapefruit juice as it can lead to dangerous side effects.

Correct answer: A

Rationale: The correct answer is A. Sildenafil is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and sildenafil both cause vasodilation, leading to a synergistic effect that can result in a dangerous drop in blood pressure. Choices B, C, and D are incorrect because there is no specific contraindication for taking sildenafil with food, having a history of hypertension, or taking it with grapefruit juice. The main concern is the concurrent use of nitrates with sildenafil.

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