Nursing Elites

1. Which clients are at highest risk for pneumonia?

• A. Those in their 20s and 30s and generally healthy
• B. Those who exercise regularly and are not exposed to pathogens
• C. Those who are hospitalized and immunocompromised
• D. Those who have adequate respiratory function

Correct answer: C

Rationale: Clients who are hospitalized and immunocompromised are at the highest risk for pneumonia due to their weakened immune systems. Choice A is incorrect as young and healthy individuals typically have stronger immune systems. Choice B is incorrect because regular exercise can actually boost the immune system and reduce the risk of infections. Choice D is incorrect as having adequate respiratory function does not necessarily correlate with the risk of developing pneumonia.

2. A patient is prescribed tadalafil (Cialis) for erectile dysfunction. What specific contraindication should the nurse discuss with the patient?

• A. History of hypertension
• B. Use of nitrates
• C. Use of antihypertensive medications
• D. History of peptic ulcer disease

Correct answer: B

Rationale: The correct answer is B: 'Use of nitrates.' Tadalafil (Cialis) is contraindicated in patients taking nitrates due to the risk of severe hypotension. Nitrates and Cialis both cause vasodilation, which can lead to a dangerous drop in blood pressure when used together. Choices A, C, and D are incorrect because a history of hypertension, use of antihypertensive medications, and a history of peptic ulcer disease are not specific contraindications for tadalafil use.

3. A 37-year-old woman has a 10 pack-year smoking history and has been using oral contraceptives for the past 2 years. The nurse should plan health education interventions knowing that this patient faces an increased risk of

• A. osteoporosis.
• B. dementia.
• C. myocardial infarction.
• D. deep vein thrombosis.

Correct answer: C

Rationale: The correct answer is C: myocardial infarction. Women aged 35 and older who smoke, especially with a history of 10 pack-years like in this case, face an increased risk of cardiovascular disorders, including myocardial infarction, when using oral contraceptives. Choice A, osteoporosis, is incorrect because smoking and oral contraceptives do not significantly increase the risk of osteoporosis. Choice B, dementia, is not directly associated with smoking, oral contraceptives, or their combination. Choice D, deep vein thrombosis, is a risk associated with oral contraceptives, especially in combination with smoking, but the highest increased risk in this case is for myocardial infarction.

4. 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.

5. A secondary immune response differs from the primary immune response in that:

• A. It is more rapid than the primary response and results in higher antibody levels
• B. It is slower than the primary response and doesn't change the antibody levels
• C. It occurs at the same time as the primary response but results in a decrease in antibodies
• D. It only occurs in hyperallergic reactions and results in a decrease in antibodies

Correct answer: A

Rationale: The correct answer is A. A secondary immune response is characterized by being more rapid than the primary response and results in higher antibody levels. This is because memory B cells are already present and can quickly differentiate into plasma cells upon re-exposure to the antigen. Choice B is incorrect because a secondary immune response is faster, not slower, than the primary response, and it does lead to higher antibody levels. Choice C is incorrect because a secondary response does not result in a decrease in antibodies; instead, it leads to an increase. Choice D is incorrect because a secondary immune response is not limited to hyperallergic reactions, and it results in an increase, not a decrease, in antibodies.

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