Nursing Elites

1. What tool is used to determine a client’s level of consciousness?

• A. Magnetic resonance imaging (MRI)
• B. Glasgow Coma Scale (GCS)
• C. Central perfusion pressure (CPP)
• D. Intracranial pressure (ICP) monitoring

Correct answer: B

Rationale: The correct answer is B: Glasgow Coma Scale (GCS). The Glasgow Coma Scale is specifically designed to assess a client's level of consciousness by evaluating verbal, motor, and eye-opening responses. Choice A, Magnetic Resonance Imaging (MRI), is a diagnostic imaging tool that provides detailed images of the body's organs and tissues but is not used to assess consciousness levels. Choice C, Central Perfusion Pressure (CPP), and Choice D, Intracranial Pressure (ICP) monitoring, are related to hemodynamic monitoring and intracranial pressure management, not direct assessment of consciousness.

2. A patient is receiving epoetin alfa (Epogen) for anemia. Which of the following adjunctive therapies is imperative with epoetin alfa?

• A. Potassium supplements
• B. Sodium restriction
• C. Iron supplement
• D. Renal dialysis

Correct answer: C

Rationale: The correct answer is C: Iron supplement. When a patient is receiving epoetin alfa for anemia, it is imperative to provide iron supplementation as epoetin alfa works by stimulating the production of red blood cells, which require iron for hemoglobin synthesis. Therefore, iron supplementation is crucial to support the increased erythropoiesis. Choices A, B, and D are incorrect because potassium supplements, sodium restriction, and renal dialysis are not typically indicated as adjunctive therapies with epoetin alfa for anemia.

3. Which of the following patients are at higher risk for developing oral cancer?

• A. A female who has taken oral contraceptives for the last 4 years
• B. Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe
• C. An adult female who eats spicy foods regularly
• D. An older adult female who chews gum frequently

Correct answer: B

Rationale: The correct answer is 'Both an adult male with a history of alcoholism and a middle-aged male who smokes a pipe.' Alcohol consumption and tobacco use, such as smoking a pipe, are well-known risk factors for developing oral cancer. These two factors significantly increase the likelihood of developing oral cancer compared to the other choices. Taking oral contraceptives, eating spicy foods regularly, and chewing gum frequently are not established risk factors for oral cancer, making them less likely to lead to the development of this type of cancer.

4. A patient is receiving intravenous amphotericin. Which of the following assessments warrants the discontinuation of the antifungal agent?

• A. Sodium level of 138 mEq/L
• B. Hematocrit of 39%
• C. Blood urea nitrogen of 60 mg/dL
• D. AST level of 10 Unit/L

Correct answer: C

Rationale: Intravenous amphotericin can cause nephrotoxicity, leading to increased blood urea nitrogen levels. Elevated blood urea nitrogen (BUN) indicates impaired renal function, which is a known adverse effect of amphotericin. Therefore, a BUN level of 60 mg/dL warrants the discontinuation of the antifungal agent. The other options, such as a sodium level of 138 mEq/L, hematocrit of 39%, and AST level of 10 Unit/L, are within normal ranges and not indicative of the need to discontinue amphotericin therapy.

5. When arterial blood pressure declines, the kidneys secrete a hormone to increase blood pressure and peripheral resistance. What is this hormone called?

• A. Renin
• B. Antidiuretic hormone
• C. Atrial natriuretic
• D. Insulin

Correct answer: A

Rationale: Renin is the correct answer. When arterial blood pressure decreases, the kidneys release renin, which triggers a series of reactions ultimately leading to an increase in blood pressure and peripheral resistance. Antidiuretic hormone (choice B) is involved in water retention, atrial natriuretic hormone (choice C) promotes sodium excretion and lowers blood pressure, and insulin (choice D) regulates glucose metabolism, not blood pressure.

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