Nursing Elites

1. The nurse admits a patient who has a diagnosis of an acute asthma attack. Which statement indicates that the patient may need teaching regarding medication use?

• A. I have not had any acute asthma attacks during the last year.
• B. I became short of breath an hour before coming to the hospital.
• C. I've been taking Tylenol 650 mg every 6 hours for chest-wall pain.
• D. I've been using my albuterol inhaler more frequently over the last 4 days.

Correct answer: I've been using my albuterol inhaler more frequently over the last 4 days.

Rationale: The correct answer is 'I've been using my albuterol inhaler more frequently over the last 4 days.' This statement indicates that the patient may need teaching regarding medication use because an increased need for a rapid-acting bronchodilator suggests an exacerbation of asthma. The patient should be educated on recognizing worsening symptoms and the appropriate actions to take. Choices A, B, and C do not directly relate to asthma exacerbation or the need for medication teaching, making them incorrect. Choice A reflects a lack of recent acute asthma attacks, while choice B describes shortness of breath unrelated to medication use. Choice C mentions Tylenol use for chest-wall pain, which is not indicative of asthma exacerbation or medication teaching needs.

2. What is the likely cause of pericarditis in a young patient?

• A. Heart failure
• B. Acute MI
• C. Hypertension
• D. Infectious processes

Correct answer: Infectious processes

Rationale: In younger patients, pericarditis is typically caused by an infection commonly triggered by viruses like the Coxsackie virus, streptococcus, staphylococcus, or Haemophilus influenzae. Infectious processes are the leading cause of pericarditis in younger individuals. Heart failure, Acute MI, and Hypertension are not common causes of pericarditis in young patients. In older adults, acute myocardial infarction (MI) is a more common cause of pericarditis.

3. A 1-year-old child is diagnosed with intussusception, and the mother of the child asks the student nurse to describe the disorder. Which statement by the student nurse indicates correct understanding of this disorder?

• A. It is an acute bowel obstruction.
• B. It is a condition that causes an acute inflammatory process in the bowel.
• C. It is a condition in which a distal segment of the bowel prolapses into a proximal segment of the bowel.
• D. It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel.

Correct answer: It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel.

Rationale: Intussusception is a condition in which a proximal segment of the bowel telescopes or prolapses into a distal segment of the bowel. This leads to bowel obstruction and potential ischemia. It is not an acute bowel obstruction, as the obstruction is caused by the telescoping of bowel segments rather than a blockage in the bowel lumen. Intussusception is not primarily an inflammatory process; instead, it is a mechanical issue involving bowel invagination. Choice A is incorrect as it does not accurately describe the pathophysiology of intussusception. Choice C is incorrect because it presents the opposite scenario of what happens in intussusception.

4. Which response would best assist the chemically impaired client in dealing with issues of guilt?

• A. Addiction usually causes people to feel guilty. Don’t worry, it is a typical response due to your drinking behavior.
• B. What have you done that you feel most guilty about and what steps can you begin to take to help you lessen this guilt?
• C. Don’t focus on your guilty feelings. These feelings will only lead you to drinking and taking drugs.
• D. You’ve caused a great deal of pain to your family and close friends, so it will take time to undo all the things you’ve done.

Correct answer: What have you done that you feel most guilty about and what steps can you begin to take to help you lessen this guilt?

Rationale: The correct response is, 'What have you done that you feel most guilty about and what steps can you begin to take to help you lessen this guilt?' This response encourages the client to reflect on their actions, identify sources of guilt, and develop a plan to address and reduce these feelings constructively. Choice A is incorrect as it dismisses the client's guilt as typical, potentially invalidating their emotions. Choice C is incorrect as it suggests avoiding guilty feelings by turning to substance use, which is counterproductive. Choice D is incorrect as it focuses on the negative consequences of the client's actions without offering a constructive way to address and alleviate guilt.

5. A systolic blood pressure of 145 mm Hg is classified as:

• A. Normotensive
• B. Prehypertension
• C. Stage I hypertension
• D. Stage II hypertension

Correct answer: C: Stage I hypertension

Rationale: A systolic blood pressure of 145 mm Hg falls within the range of 140-159 mm Hg, which is classified as Stage I hypertension. Normotensive individuals have a systolic blood pressure less than 120 mm Hg, making choice A incorrect. Prehypertension is characterized by a systolic blood pressure ranging from 120-139 mm Hg, excluding choice B. Stage II hypertension is diagnosed when the systolic blood pressure is greater than 160 mm Hg, making choice D incorrect. Therefore, the correct classification for a systolic blood pressure of 145 mm Hg is Stage I hypertension.

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