Nursing Elites

1. Which of the following lab values would indicate symptomatic AIDS in the medical chart? (T4 cell count per deciliter)

• A. Greater than 1000 cells per deciliter
• B. Less than 500 cells per deciliter
• C. Greater than 2000 cells per deciliter
• D. Less than 200 cells per deciliter

Correct answer: D

Rationale: A T4 cell count of less than 200 cells per deciliter indicates symptomatic AIDS. This severe depletion of T4 cells signifies advanced HIV infection and a significantly compromised immune system. Choices A, B, and C are incorrect because T4 cell counts above 2000, above 1000, or below 500 cells per deciliter, respectively, are not indicative of symptomatic AIDS.

2. The client has jaundice, elevated liver enzymes, and an elevated serum bilirubin. What color urine does the nurse expect to find?

• A. Pink-tinged
• B. Straw-colored
• C. Clear
• D. Dark amber

Correct answer: D

Rationale: The correct answer is dark amber. In jaundice, the elevated bilirubin levels are excreted in the urine, giving it a dark amber color. Choices A, B, and C are incorrect because in jaundice, the urine typically appears dark amber due to the presence of elevated bilirubin, not pink-tinged, straw-colored, or clear.

3. A client asks a nurse working in a dental office what type of drug the dentist uses to provide anesthesia during the extraction of the client's wisdom teeth. The dentist uses an anesthetic gas, also known as laughing gas. This agent is:

• A. nitrous oxide.
• B. nitrogen.
• C. nitric oxide.
• D. nitrogen dioxide.

Correct answer: A

Rationale: The correct answer is nitrous oxide. Nitrous oxide is commonly known as laughing gas and is used as an anesthetic gas for procedures like dental extractions. It produces analgesia and mild euphoria without loss of consciousness. Nitrogen is a nonmetallic element found in air, while nitric oxide is a vasodilator produced from L-arginine. Nitrogen dioxide is a poisonous gas found in smog and exhaust fumes and is not used for anesthesia.

4. Which of the following medications is a serotonin antagonist that might be used to relieve nausea and vomiting?

• A. metoclopramide (Reglan)
• B. ondansetron (Zofran)
• C. hydroxyzine (Vistaril)
• D. prochlorperazine (Compazine)

Correct answer: B

Rationale: Zofran is a serotonin antagonist that can be used to relieve nausea and vomiting. Ondansetron (Zofran) works by blocking serotonin receptors in the chemoreceptor trigger zone (CTZ) and the gastrointestinal tract. This action helps reduce nausea and vomiting. Metoclopramide (Reglan) works as a dopamine antagonist and also has prokinetic effects, making it effective for different conditions. Hydroxyzine (Vistaril) is an antihistamine with antiemetic properties, but it does not act as a serotonin antagonist. Prochlorperazine (Compazine) is a dopamine antagonist that is also used to treat nausea and vomiting, but not as a serotonin antagonist like ondansetron.

5. While performing wound care to a donor skin graft site, the nurse notes some scabbing at the edges and a black collection of blood. What is the nurse's next action?

• A. Leave the scabbed area alone and apply extra ointment
• B. Notify the physician
• C. Gently remove the debris and re-dress the wound
• D. Apply skin softening lotion for 3 hours and then re-dress

Correct answer: C

Rationale: When the nurse notes scabbing at the edges and a black collection of blood, it indicates the presence of debris that needs to be addressed. Leaving the scabbed area alone and applying extra ointment may not address the underlying issue and could lead to complications. Notifying the physician is important in some cases, but immediate action is required to prevent infection in this situation. Gently removing the debris and re-dressing the wound is the correct course of action to promote healing and prevent complications.

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