Nursing Elites

1. Following a knee injury, a football player is taking ibuprofen, a nonsteroidal anti-inflammatory drug, for the control of pain. Which drug action is most likely to result in diminished sensation of pain for the player?

• A. Inhibition of cyclooxygenase (COX) enzymes
• B. Activation of opioid receptors
• C. Blocking of NMDA receptors
• D. Stimulation of serotonin receptors

Correct answer: A

Rationale: The correct answer is A: Inhibition of cyclooxygenase (COX) enzymes. Ibuprofen works by inhibiting these enzymes, which are involved in the production of prostaglandins that mediate pain and inflammation. This inhibition leads to decreased prostaglandin production, resulting in a decrease in pain and inflammation. Choices B, C, and D are incorrect because ibuprofen does not act on opioid receptors, NMDA receptors, or serotonin receptors to control pain. It primarily exerts its analgesic and anti-inflammatory effects through COX enzyme inhibition.

2. A 21-year-old male is brought to the ED following a night of partying in his fraternity. His friends found him 'asleep' and couldn't get him to respond. They cannot recall how many alcoholic beverages he drank the night before. While educating a student nurse and the man's friends, the nurse begins by explaining that alcohol is:

• A. A water-soluble compound that is easily absorbed by the gastric lining of the stomach.
• B. Very lipid-soluble and rapidly crosses the blood–brain barrier.
• C. Able to reverse the transport of some substances to remove them from the brain.
• D. Very likely to cause sedation and therefore the client just needs to sleep it off.

Correct answer: B

Rationale: The correct answer is B. Alcohol is very lipid-soluble and rapidly crosses the blood–brain barrier, leading to its effects on the central nervous system and causing symptoms like sedation and unconsciousness. Choice A is incorrect because alcohol is not water-soluble; it is lipid-soluble. Choice C is incorrect as alcohol does not reverse the transport of substances from the brain. Choice D is incorrect as sedation from alcohol is not a reason to just 'sleep it off' in cases of alcohol poisoning, which can be life-threatening and requires medical attention.

3. A male patient with erectile dysfunction has asked for a prescription for sildenafil (Viagra). Before giving this medication, the nurse should assess for which of the following conditions?

• A. History of peptic ulcer disease
• B. Use of nitrates
• C. Recent history of a stroke
• D. History of hypertension

Correct answer: B

Rationale: The correct answer is B: Use of nitrates. Sildenafil should not be used by patients taking nitrates due to the risk of severe hypotension. Nitrates can potentiate the hypotensive effects of sildenafil, leading to a significant drop in blood pressure. Assessing for the use of nitrates is crucial to avoid this potentially dangerous interaction. Choices A, C, and D are incorrect because they are not specifically contraindications for the use of sildenafil. While a history of hypertension should be considered, it is not as critical as the use of nitrates when prescribing sildenafil.

4. After studying about viruses, which information indicates the student has a good understanding of viruses? Viruses:

• A. Contain no RNA or DNA
• B. Are capable of independent reproduction
• C. Replicate their genetic material inside host cells
• D. Are killed easily by antimicrobials

Correct answer: C

Rationale: The correct answer is C. Viruses replicate their genetic material inside host cells, which is a fundamental aspect of their life cycle. Choice A is incorrect because viruses contain either RNA or DNA. Choice B is incorrect as viruses cannot reproduce independently and rely on host cells for replication. Choice D is incorrect as viruses are not easily killed by antimicrobials due to their unique structure and mechanisms of infection.

5. A client with a history of hypertension presents with a severe headache and blurred vision. What is the nurse's priority action?

• A. Administer pain relief medication.
• B. Obtain a stat head CT scan.
• C. Administer antihypertensive medications as prescribed.
• D. Call the healthcare provider immediately.

Correct answer: C

Rationale: The correct answer is to administer antihypertensive medications as prescribed. In a client with a history of hypertension presenting with severe headache and blurred vision, these symptoms could indicate a hypertensive crisis. The priority action is to lower the blood pressure promptly to prevent complications such as stroke, heart attack, or organ damage. Administering antihypertensive medications is crucial in this situation. Administering pain relief medication (Choice A) may temporarily alleviate symptoms but does not address the underlying issue of elevated blood pressure. Obtaining a stat head CT scan (Choice B) may be necessary to rule out other causes but should not delay the administration of antihypertensive medications. Calling the healthcare provider immediately (Choice D) is important but may not address the immediate need to lower blood pressure in a hypertensive crisis.

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