Nursing Elites

1. What lab value should be prioritized for a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Serum albumin levels
• C. White blood cell count
• D. Hemoglobin levels

Correct answer: A

Rationale: A CD4 T-cell count below 180 cells/mm3 should be prioritized for a patient with HIV. This value is crucial as it indicates severe immunocompromise in HIV-infected individuals. Monitoring CD4 T-cell count helps assess the status of the immune system and guides treatment decisions. Serum albumin levels (choice B) may reflect the patient's nutritional status and overall health but are not as specific to HIV disease progression. White blood cell count (choice C) and hemoglobin levels (choice D) can be affected by various factors and are not as directly linked to HIV management as the CD4 T-cell count in this context.

2. What lab value should be prioritized for monitoring in a patient with HIV?

• A. CD4 T-cell count below 180 cells/mm3
• B. Hemoglobin levels
• C. Serum albumin levels
• D. White blood cell count

Correct answer: A

Rationale: The correct answer is A: CD4 T-cell count below 180 cells/mm3. Monitoring CD4 T-cell count is crucial in patients with HIV as it reflects the status of their immune system. A CD4 count below 200 cells/mm3 is indicative of severe immunocompromise, necessitating close monitoring and potential intervention. Choices B, C, and D are less specific to HIV management and do not directly reflect the immune status in these patients. Hemoglobin levels are more relevant for assessing anemia, serum albumin levels for nutritional status, and white blood cell count for overall immune response, but none are as directly tied to HIV disease progression as the CD4 T-cell count.

3. A nurse is preparing to discharge a client who has a new diagnosis of chronic kidney disease (CKD). Which of the following referrals should the nurse plan to initiate?

• A. Respiratory therapy
• B. Hospice care
• C. Occupational therapy
• D. Dietary services

Correct answer: D

Rationale: The correct answer is D: Dietary services. Referring the client to dietary services is essential for managing nutrition, including monitoring sodium, potassium, and protein intake, which are crucial aspects of managing chronic kidney disease (CKD). Respiratory therapy (choice A) focuses on managing respiratory conditions, which are not directly related to CKD. Hospice care (choice B) is not appropriate for a new diagnosis of CKD as it is designed for end-of-life care. Occupational therapy (choice C) is beneficial for improving activities of daily living but is not the priority referral for a new CKD diagnosis.

4. What is the first medication to give to a patient with wheezing due to an allergic reaction?

• A. Albuterol via nebulizer
• B. Methylprednisolone 100 mg IV
• C. Cromolyn 20 mg via nebulizer
• D. Aminophylline 500 mg IV

Correct answer: A

Rationale: The correct answer is A, Albuterol via nebulizer. Albuterol is the first-line treatment for wheezing caused by an allergic reaction because it is a fast-acting bronchodilator that helps to quickly open the airways, providing immediate relief of symptoms. Choice B, Methylprednisolone 100 mg IV, is a corticosteroid used for its anti-inflammatory effects but is not the initial medication for acute wheezing in an allergic reaction. Choice C, Cromolyn 20 mg via nebulizer, is a mast cell stabilizer that can be used for prevention but is not the first choice for acute symptom relief. Choice D, Aminophylline 500 mg IV, is a bronchodilator with a narrow therapeutic window and more side effects compared to Albuterol, making it a less preferred option as the initial treatment.

5. The nurse misread a patient's glucose as 210 mg/dL instead of 120 mg/dL and administered the insulin dose for a reading over 200 mg/dL. What is the priority action?

• A. Administer glucose IV
• B. Monitor for hyperglycemia
• C. Monitor for hypoglycemia
• D. Document the incident

Correct answer: C

Rationale: The priority action is to monitor the patient for signs of hypoglycemia as the nurse administered excess insulin due to misreading the glucose level. Administering glucose IV (Choice A) is not the immediate priority when dealing with hypoglycemia. Monitoring for hyperglycemia (Choice B) is not the correct action as the insulin was administered for a higher glucose reading. Documenting the incident (Choice D) is important but not the priority when the patient's safety is at risk due to possible hypoglycemia.

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