Nursing Elites

1. A client has viral pneumonia affecting 2/3 of the right lung. What would be the best position to teach the client to lie in every other hour during the first 12 hours after admission?

• A. Side-lying on the left with the head elevated 10 degrees
• B. Side-lying on the left with the head elevated 35 degrees
• C. Side-lying on the right with the head elevated 10 degrees
• D. Side-lying on the right with the head elevated 35 degrees

Correct answer: A

Rationale: The correct answer is side-lying on the left with the head elevated 10 degrees. This position maximizes ventilation and promotes better perfusion to the unaffected lung. Placing the client in this position helps to optimize oxygenation and reduce pressure on the affected lung. Choices B, C, and D are incorrect because lying on the left side with the head elevated is essential to facilitate better lung expansion and gas exchange in the unaffected lung, while lying on the right side could further compromise the affected lung by increasing pressure on it.

2. A client is admitted with pneumonia and is started on antibiotics. After 3 days, the client reports difficulty breathing and a rash. What is the nurse's first action?

• A. Administer epinephrine
• B. Discontinue the antibiotic
• C. Assess the client's oxygen saturation
• D. Call the healthcare provider

Correct answer: B

Rationale: The client's difficulty breathing and rash suggest a possible allergic reaction to the antibiotic. The first action the nurse should take is to discontinue the antibiotic to prevent further exposure. Administering epinephrine should only be done in severe cases of anaphylaxis, which is not indicated solely by difficulty breathing and rash. While assessing the client's oxygen saturation is important, discontinuing the potential allergen takes precedence. Contacting the healthcare provider should be done after discontinuing the antibiotic and assessing the client to report the situation and seek further guidance.

3. A client with hypertension is prescribed a low-sodium diet. What is the most important instruction for the nurse to provide?

• A. Limit sodium intake to 2 grams per day.
• B. Choose fresh fruits and vegetables.
• C. Drink at least 8 glasses of water daily.
• D. Avoid processed foods and canned soups.

Correct answer: D

Rationale: The correct answer is D. Avoiding processed foods and canned soups is crucial for a client with hypertension on a low-sodium diet because these foods are typically high in sodium content. Fresh fruits and vegetables are generally healthy choices but may still contain some natural sodium. While limiting sodium intake to 2 grams per day is important, specifically avoiding processed foods and canned soups is more critical in this situation. Drinking water is essential for overall health but is not the most important instruction when focusing on reducing sodium intake.

4. A child has a nosebleed (epistaxis) while playing soccer. In what position should the nurse place the child?

• A. Position the child lying flat and apply pressure to the bridge of the nose.
• B. Position the child sitting up and leaning forward.
• C. Have the child tilt the head back and pinch the nose.
• D. Position the child lying on their side and apply ice to the nose.

Correct answer: B

Rationale: The correct answer is to position the child sitting up and leaning forward. This position helps prevent blood from flowing down the throat, reducing the risk of choking or vomiting. Choice A is incorrect because lying flat can cause blood to flow down the throat. Choice C is wrong as tilting the head back may lead to blood entering the throat. Choice D is also incorrect as applying ice is not recommended for nosebleeds and lying on the side may not prevent blood from flowing down the throat.

5. A client with hypothyroidism is prescribed levothyroxine. What symptom indicates that the dosage may need adjustment?

• A. Increased appetite and weight gain.
• B. Increased sensitivity to cold and dry skin.
• C. Increased heart palpitations and sweating.
• D. Increased shortness of breath and rapid heart rate.

Correct answer: B

Rationale: Increased sensitivity to cold and dry skin may indicate that the dosage of levothyroxine is too low, requiring adjustment. This symptom is typical of hypothyroidism when the body's metabolism slows down, leading to feeling cold and having dry skin. Choices A, C, and D present symptoms more commonly associated with hyperthyroidism, where the body is in a state of overactivity, leading to weight loss, increased heart rate, and sweating. Therefore, these symptoms would not indicate the need for dosage adjustment in a client with hypothyroidism.

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