Nursing Elites

1. A client is admitted for COPD. Which finding would require the nurse's immediate attention?

• A. Nausea and vomiting
• B. Restlessness and confusion
• C. Low-grade fever and cough
• D. Irritating cough and liquefied sputum

Correct answer: B

Rationale: Restlessness and confusion are signs of hypoxia and hypercapnia in a client with COPD, indicating that the client's condition may be deteriorating rapidly. Immediate attention is necessary to prevent further complications. Nausea and vomiting (Choice A) may be related to various factors but do not directly indicate respiratory distress. Low-grade fever and cough (Choice C) are common in COPD and may not require immediate intervention. Irritating cough and liquefied sputum (Choice D) are typical symptoms of COPD exacerbation but do not signal an immediate need for attention as restlessness and confusion.

2. The hospital is planning to downsize and eliminate a number of staff positions as a cost-saving measure. To assist staff in this change process, the nurse manager is preparing for the "unfreezing" phase of change. With this approach and phase the nurse manager should

• A. Discuss with the staff how to deal with any defensive behavior
• B. Explain to the unit staff why change is necessary
• C. Assist the staff during the acceptance of the new changes
• D. Clarify what the changes mean to the community and hospital

Correct answer: B

Rationale: The "unfreezing" phase involves preparing staff for change by explaining the necessity and benefits of the change, helping them to understand and accept it.

3. Which finding would be the most characteristic of an acute episode of reactive airway disease?

• A. Auditory gurgling
• B. Inspiratory laryngeal stridor
• C. Auditory expiratory wheezing
• D. Frequent dry coughing

Correct answer: C

Rationale: The correct answer is C: Auditory expiratory wheezing. Expiratory wheezing is a common sign of reactive airway disease, such as asthma, where airways are constricted, making it difficult to expel air from the lungs. Choices A, B, and D are incorrect as they are not typically associated with reactive airway disease. Auditory gurgling may suggest airway secretions or fluid accumulation, inspiratory laryngeal stridor indicates upper airway obstruction, and frequent dry coughing is more commonly seen in conditions like upper respiratory infections or postnasal drip.

4. What is the process of enabling people to increase control over and improve their health known as?

• A. Health promotion
• B. Disease prevention
• C. Rehabilitation
• D. Health education

Correct answer: A

Rationale: The correct answer is A: Health promotion. Health promotion focuses on empowering individuals to take control of their health by promoting healthy behaviors, lifestyles, and environments. It aims to prevent illnesses and enhance overall well-being. Choices B, C, and D are incorrect because they do not fully encompass the concept of empowering individuals to improve their health. Disease prevention specifically targets avoiding specific illnesses, rehabilitation focuses on restoring health after an illness or injury, and health education primarily involves imparting knowledge about health-related topics.

5. The school RN is assessing a group of middle school students for signs of scoliosis and discovers a female student with noticeable unequal symmetry of the upper and lower back. Which intervention is most important for the RN to implement?

• A. Send the student home
• B. Make a referral to have the scoliosis further evaluated.
• C. Withdraw the student from all physical activities
• D. Tell the student not to carry her backpack on her back

Correct answer: B

Rationale: Referring the student for further evaluation of scoliosis is crucial to confirm the diagnosis and determine the appropriate management plan. Sending the student home (choice A) without proper assessment and intervention is not the best course of action. Withdrawing the student from all physical activities (choice C) is not necessary and may cause unnecessary distress. Instructing the student not to carry her backpack on her back (choice D) does not address the underlying issue of scoliosis and is not the most important intervention at this point.

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