Nursing Elites

1. Which lab value is a priority for a patient with HIV?

• A. CD4 T-cell count 180 cells/mm3
• B. Albumin levels below 3.5 g/dL
• C. Potassium levels below 3.5 mEq/L
• D. White blood cell count below 5000/mm3

Correct answer: A

Rationale: A CD4 T-cell count of less than 180 cells/mm3 is a priority for a patient with HIV because it indicates severe immunocompromise and an increased risk for opportunistic infections. Monitoring CD4 levels helps in assessing the immune status and guiding treatment decisions in patients with HIV. Albumin levels (choice B) are important for assessing nutritional status but are not a direct indicator of immune function in HIV patients. Potassium levels (choice C) and white blood cell count (choice D) are also important, but the CD4 T-cell count is specifically crucial for evaluating the immune function in individuals with HIV.

2. A patient is admitted with chest pain, possible acute coronary syndrome. What should the nurse do first?

• A. Administer sublingual nitroglycerin
• B. Get IV access
• C. Obtain cardiac enzymes
• D. Auscultate heart sounds

Correct answer: A

Rationale: In a patient with chest pain, possible acute coronary syndrome, the nurse should administer sublingual nitroglycerin first. Nitroglycerin helps to vasodilate coronary arteries, improving blood flow to the heart, and reducing cardiac workload. This can alleviate chest pain and decrease cardiac tissue damage in acute coronary syndrome. Getting IV access, obtaining cardiac enzymes, and auscultating heart sounds are important steps in the assessment and management of acute coronary syndrome, but administering nitroglycerin to relieve chest pain and improve blood flow takes precedence as it directly addresses the patient's symptoms and aims to prevent further cardiac damage.

3. What medication should be given first to a patient experiencing wheezing and coughing due to an allergic reaction?

• A. Albuterol 3 ml via nebulizer
• B. Cromolyn via nebulizer
• C. Aminophylline IV
• D. Methylprednisolone 100 mg IV

Correct answer: A

Rationale: The correct answer is Albuterol 3 ml via nebulizer. Albuterol is a bronchodilator that helps relieve wheezing and coughing by opening up the airways, making it the first-line treatment for allergic reactions presenting with these symptoms. Cromolyn and aminophylline are not typically used as first-line treatments for acute allergic reactions with wheezing and coughing. Methylprednisolone, a corticosteroid, may be beneficial for inflammation in the setting of an allergic reaction but is not the initial medication of choice to address wheezing and coughing.

4. A healthcare provider is assessing a client who reports a possible exposure to HIV. Which of the following findings should the healthcare provider identify as an early manifestation of HIV infection?

• A. Stomatitis
• B. Fatigue
• C. Wasting syndrome
• D. Lipodystrophy

Correct answer: B

Rationale: The correct answer is 'B: Fatigue.' Early manifestations of HIV infection often include symptoms like fatigue, fever, and rash, which are typical of viral infections. Stomatitis (choice A) refers to inflammation of the mouth and lips, which can occur in HIV but is not specific to early infection. Wasting syndrome (choice C) and lipodystrophy (choice D) are more commonly associated with later stages of HIV infection rather than early manifestations.

5. A patient is receiving discharge instructions for GERD. Which of the following statements by the patient demonstrates an understanding of the teaching?

• A. I should take my medication with orange juice.
• B. Having a bedtime snack will prevent heartburn.
• C. I will lie down after meals.
• D. I will limit activities that require bending at the waist.

Correct answer: D

Rationale: The correct answer is D. Patients with GERD should avoid activities that increase intra-abdominal pressure, such as bending at the waist, as this can lead to reflux. Choice A is incorrect because medications for GERD are usually taken with water, not citrus juices. Choice B is incorrect as having a bedtime snack can worsen GERD symptoms. Choice C is incorrect because lying down after meals can also exacerbate reflux due to the effects of gravity.

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