Nursing Elites

1. An influenza outbreak has spread through a long-term care residence, affecting many of the residents with severe malaise, fever, and nausea and vomiting. In an effort to curb the outbreak, the nurse has liaised with a physician to see if residents may be candidates for treatment with what drug?

• A. Saquinavir mesylate
• B. Oseltamivir phosphate
• C. Lamivudine
• D. Ribavirin

Correct answer: B

Rationale: The correct answer is B: Oseltamivir phosphate. Oseltamivir is an antiviral medication used to treat influenza infections. It works by inhibiting the neuraminidase enzyme of the influenza virus, reducing the spread of the virus in the body. Saquinavir mesylate (choice A) is used in the treatment of HIV, not influenza. Lamivudine (choice C) is also an antiviral medication primarily used in the treatment of HIV and hepatitis B, not influenza. Ribavirin (choice D) is used to treat certain viral infections like hepatitis C, respiratory syncytial virus (RSV), and some viral hemorrhagic fevers, but it is not a first-line treatment for influenza.

2. When a child jumps out of the tub, crying and stating her feet are 'burning,' what pathophysiologic principle is responsible for this response?

• A. Pain receptors (nociceptors) have been activated in response to a thermal stimulus.
• B. The child's skin thermal receptors have undergone adaptation.
• C. The child is exhibiting a psychogenic pain response due to anxiety.
• D. The child is experiencing a conditioned pain response based on previous experiences.

Correct answer: A

Rationale: The child's reaction is due to the activation of nociceptors, which are pain receptors that respond to thermal stimuli. This response is an immediate protective mechanism to prevent tissue damage caused by extreme temperatures. Option B is incorrect because adaptation does not explain the child's immediate and intense response. Option C is incorrect as there is a clear physical stimulus present, ruling out a psychogenic response. Option D is incorrect as the child's response is not based on previous experiences but rather on the current thermal stimulus.

3. A client with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days after the amputation, the client confides in the nurse that he still feels his right foot. Knowing the pathophysiologic principles behind this, the nurse can:

• A. administer a psychotropic medication to help the client cope with the sensation of his amputated leg.
• B. explain that many amputees have this sensation and that one theory surmises the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site.
• C. call the physician and request an order for a psychological consult.
• D. educate the client that this area has an unusually abnormal increase in sensitivity to sensation but that it will go away with time.

Correct answer: B

Rationale: The correct answer is B. The sensation of feeling the amputated limb is known as phantom limb pain, which is common after amputation. One theory suggests that it occurs because the end of a regenerating nerve becomes trapped in the scar tissue at the amputation site. Administering psychotropic medication (choice A) is not the first-line treatment for phantom limb pain. Requesting a psychological consult (choice C) is premature without first addressing the known pathophysiological basis of phantom limb pain. Educating the client that the sensitivity will go away with time (choice D) is not entirely accurate as phantom limb pain can persist long-term.

4. 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.

5. Why is testosterone therapy prescribed for a 70-year-old man being treated for osteoporosis?

• A. To increase bone density
• B. To reduce the risk of fractures
• C. To enhance sexual performance
• D. To restore testosterone levels

Correct answer: D

Rationale: The primary reason for prescribing testosterone therapy for osteoporosis in men is to restore testosterone levels, not specifically to increase bone density. Testosterone plays a crucial role in maintaining bone density, so by restoring testosterone levels, it indirectly helps in maintaining bone density. Choices A and B are partially correct but do not address the primary reason for testosterone therapy in this context. Choice C is incorrect as the main focus of testosterone therapy in osteoporosis treatment is not related to enhancing sexual performance.

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