Nursing Elites

1. A female client with a history of chronic obstructive pulmonary disease (COPD) is being treated at home and is currently receiving oxygen at 2 liters via nasal cannula. The spouse, who is the caregiver, reports that the client requires assistance when ambulating short distances, including going to the bathroom. Which suggestion should the health care nurse provide to the caregiver?

• A. disconnect oxygen when ambulating to the bathroom
• B. administer a breathing treatment prior to ambulation
• C. suggest obtaining a bedside commode for toileting
• D. ask for additional assistance to reduce the risk of falls

Correct answer: C

Rationale: For a client with COPD requiring assistance for short-distance ambulation, suggesting a bedside commode for toileting is the most appropriate intervention. This recommendation helps reduce the need for the client to walk long distances, thereby minimizing the risk of exertion and potential falls. Disconnecting oxygen during ambulation (Choice A) is not safe for a client with COPD, as oxygen therapy should be continuous. Administering a breathing treatment before ambulation (Choice B) may not directly address the client's need for assistance with toileting. Asking for additional assistance (Choice D) can be beneficial but providing a bedside commode specifically addresses the current issue of ambulating short distances for toileting.

2. When visiting a community health clinic, a client's blood pressure is measured at 146/94. What information should the nurse provide the client?

• A. Participate in an exercise program for 6 weeks
• B. Obtain blood pressure daily for 2 weeks
• C. Increase dietary intake of omega-3 fatty acids
• D. Begin a low sodium diet immediately

Correct answer: D

Rationale: The correct answer is to advise the client to begin a low sodium diet immediately. High sodium intake can contribute to elevated blood pressure levels. By reducing sodium intake, blood pressure can be effectively lowered. Option A, participating in an exercise program, is beneficial for overall health but may not provide immediate impact on blood pressure. Option B, obtaining blood pressure daily for 2 weeks, may not address the underlying cause or provide immediate intervention. Option C, increasing dietary intake of omega-3 fatty acids, though beneficial for heart health, may not have an immediate impact on lowering blood pressure compared to reducing sodium intake.

3. An older adult client visits the community health clinic and reports the onset of pain, redness, and swelling of the right eye. Which question is most important for the clinic nurse to ask the client?

• A. Do you have any discharge from the eye?
• B. Have you started any new prescriptions?
• C. Are all of your immunizations current?
• D. How often do you wash your hands?

Correct answer: B

Rationale: The most important question for the nurse to ask the client is whether they have started any new prescriptions. New medications can have side effects that include eye issues, so it is crucial to determine if there is a potential link. Asking about discharge from the eye (Choice A) may be relevant but does not address the possibility of medication side effects. Inquiring about immunizations (Choice C) and handwashing frequency (Choice D) is important for overall health but is less directly related to the eye symptoms described by the client.

4. A community health nurse is conducting a neighborhood discussion group about disaster planning. What information regarding transmission of anthrax should the nurse provide to the group?

• A. Infection is acquired when anthrax spores enter a host.
• B. Mature anthrax bacteria live dormant on inanimate objects.
• C. Spores cannot survive for extended periods outside a living host.
• D. Anthrax is transmitted by respiratory droplets from person to person.

Correct answer: A

Rationale: The correct answer is A: Infection is acquired when anthrax spores enter a host. Anthrax is primarily transmitted through spores entering the body, either through the skin, inhalation, or ingestion. Person-to-person transmission of anthrax is extremely rare and not a significant mode of transmission. Choices B and C are incorrect because mature anthrax bacteria do not live dormant on inanimate objects, and spores can survive for extended periods outside a living host. Choice D is incorrect as anthrax is not transmitted by respiratory droplets from person to person.

5. During a follow-up visit, a client with diabetes reports difficulty maintaining a healthy diet. What should the nurse do first?

• A. Provide the client with meal planning resources
• B. Explore the client's dietary habits and challenges
• C. Refer the client to a nutritionist
• D. Educate the client on the importance of a healthy diet

Correct answer: B

Rationale: When a client with diabetes reports difficulty in maintaining a healthy diet, the initial action should be to explore the client's dietary habits and challenges. By doing so, the nurse can identify specific issues and barriers the client faces, which is crucial in developing a personalized and effective intervention plan. Providing meal planning resources (Choice A) can be beneficial later but should come after understanding the client's unique situation. Referring the client to a nutritionist (Choice C) may be necessary in some cases but should follow an assessment of the client's current challenges. Simply educating the client on the importance of a healthy diet (Choice D) does not address the specific difficulties the client is facing and may not lead to sustainable behavior change.

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