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. Which information would indicate more teaching is needed regarding hypersensitivity reactions? Type _______ hypersensitivity reactions involve an antibody response.

• A. I
• B. II
• C. III
• D. IV

Correct answer: D

Rationale: The correct answer is D: Type IV hypersensitivity reactions involve cell-mediated immunity, not an antibody response. This question tests knowledge of hypersensitivity reactions and their classification. Type I hypersensitivity reactions involve IgE antibodies, Type II involves IgG or IgM antibodies, and Type III involves immune complex deposition. Type IV hypersensitivity reactions are delayed and involve T cells, not antibodies. Therefore, if a person believes that Type IV hypersensitivity reactions involve an antibody response, more teaching is required.

3. A client has been admitted to the hospital with symptoms of Guillain-Barré syndrome. Which aspect of the client's condition would require priority monitoring?

• A. Monitoring oxygen saturation levels
• B. Monitoring for signs of respiratory compromise
• C. Monitoring for changes in consciousness
• D. Monitoring blood pressure closely

Correct answer: B

Rationale: In Guillain-Barré syndrome, respiratory muscle weakness can lead to respiratory compromise, making it crucial to prioritize monitoring for signs of respiratory distress. Monitoring oxygen saturation levels is important but is secondary to assessing for respiratory compromise in this condition. Changes in consciousness and monitoring blood pressure closely are not typically the priority in Guillain-Barré syndrome.

4. A female client with bone metastases secondary to lung cancer is admitted for palliative radiation treatment and pain control. The client is currently experiencing pain that she rates at 9 out of 10. Which of the following nonpharmacologic treatments is most likely to be a useful and appropriate supplement to pharmacologic analgesia at this point?

• A. Teaching the client guided imagery and meditation
• B. Initiating neurostimulation
• C. Heat therapy
• D. Relaxation and distraction

Correct answer: D

Rationale: In the scenario described, the client is experiencing high pain levels, rated at 9 out of 10. Relaxation and distraction techniques are effective nonpharmacologic interventions for managing pain. Teaching the client guided imagery and meditation (Choice A) can also be beneficial; however, in this acute situation of severe pain, relaxation and distraction techniques are more likely to provide immediate relief. Initiating neurostimulation (Choice B) and heat therapy (Choice C) may not be suitable for immediate pain relief in this scenario and are not as commonly used for managing high pain levels in palliative care settings.

5. A hospital client is at a high risk of developing bacterial endocarditis. Which of the following prophylactic measures is likely to be most effective?

• A. Avoiding exposure to individuals known to carry the streptococcus bacterium
• B. Daily administration of low-dose corticosteroids
• C. Prophylactic antimicrobial therapy before any invasive procedure
• D. Routine vaccinations against meningococcal and pneumococcal infections

Correct answer: C

Rationale: Prophylactic antimicrobial therapy before any invasive procedure is the most effective measure in preventing bacterial endocarditis in at-risk individuals. This measure helps to reduce the risk of bacterial infection during invasive procedures, which can lead to endocarditis. Choice A is incorrect as avoiding exposure to individuals with streptococcus does not address the primary preventive measure needed. Choice B is incorrect as corticosteroids do not prevent bacterial endocarditis, and daily administration is not the recommended prophylactic measure. Choice D is incorrect as routine vaccinations against meningococcal and pneumococcal infections are important for other conditions but not specifically for preventing bacterial endocarditis.

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