Nursing Elites

1. A client with chronic obstructive pulmonary disease (COPD) is prescribed home oxygen therapy. What teaching should the nurse provide?

• A. Ensure that the client uses oxygen continuously at night.
• B. Instruct the client to avoid smoking and exposure to smoke.
• C. Teach the client how to clean and replace the oxygen tubing.
• D. Instruct the client to increase their fluid intake.

Correct answer: C

Rationale: The correct teaching for a client with COPD prescribed home oxygen therapy is to educate them on how to clean and replace the oxygen tubing. This is crucial to prevent infections and ensure the effectiveness of the oxygen delivery system. Option A is not necessary as oxygen therapy is usually prescribed as needed, not continuously at night. While smoking cessation and avoiding smoke exposure are important in COPD management, it is not directly related to home oxygen therapy. Increasing fluid intake is beneficial for some conditions but is not specifically related to home oxygen therapy for COPD.

2. The nurse is providing discharge instructions to a client with chronic venous insufficiency. Which recommendation should the nurse include to help prevent complications?

• A. Use a heating pad on the legs
• B. Wear compression stockings
• C. Massage the legs daily
• D. Elevate legs for 10 minutes every hour

Correct answer: B

Rationale: The correct recommendation for a client with chronic venous insufficiency to prevent complications is to wear compression stockings. Compression stockings help improve venous circulation and prevent the worsening of symptoms. While elevating the legs is also beneficial, the priority intervention in preventing complications is wearing compression stockings. Using a heating pad on the legs can actually worsen the condition by dilating blood vessels, and massaging the legs daily can potentially damage fragile skin in clients with chronic venous insufficiency.

3. Which medication should the nurse withhold if the client's serum potassium level is 6.2 mEq/L?

• A. Losartan
• B. Spironolactone
• C. Metoprolol
• D. Furosemide

Correct answer: B

Rationale: The correct answer is B: Spironolactone. Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia. With potassium levels already elevated at 6.2 mEq/L, withholding Spironolactone is essential to prevent further increase in potassium levels, which could result in dangerous cardiac arrhythmias. Losartan (Choice A) is an angiotensin receptor blocker and does not directly affect potassium levels. Metoprolol (Choice C) is a beta-blocker and also does not impact potassium levels significantly. Furosemide (Choice D) is a loop diuretic that can actually lower potassium levels, so it would not be the medication to withhold in this case.

4. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving oxygen therapy. Which assessment finding indicates that the client's oxygenation is improving?

• A. Pulse oximetry reading of 94%
• B. Heart rate increases from 80 to 90 beats per minute
• C. Respiratory rate increases from 16 to 20 breaths per minute
• D. Client reports increased energy levels

Correct answer: A

Rationale: A pulse oximetry reading of 94% indicates adequate oxygenation. Monitoring oxygen saturation is the most objective way to assess the effectiveness of oxygen therapy. Choices B, C, and D do not directly reflect the client's oxygenation status. An increase in heart rate or respiratory rate may indicate increased work of breathing or stress on the body. The client reporting increased energy levels is subjective and may not directly correlate with improved oxygenation.

5. A client is scheduled for a colonoscopy and has been prescribed a bowel preparation. What is the most important instruction for the nurse to provide?

• A. Eat a low-fiber diet the day before the procedure
• B. Drink clear liquids 24 hours before the procedure
• C. Take the entire bowel preparation as directed
• D. Avoid all solid foods 12 hours before the procedure

Correct answer: C

Rationale: The most important instruction for the nurse to provide to a client scheduled for a colonoscopy and prescribed a bowel preparation is to take the entire bowel preparation as directed. Completing the entire bowel preparation as prescribed is crucial to ensure the colon is properly cleansed for the colonoscopy. Incomplete bowel prep can interfere with the visualization of the colon, leading to inaccurate results. Choices A, B, and D are important but not as crucial as ensuring the complete intake of the bowel preparation for an effective procedure.

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