Nursing Elites

1. A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding should the nurse expect?

• A. Increased anterior-posterior (AP) chest diameter
• B. Decreased respiratory rate
• C. Weight gain
• D. Productive cough with yellow sputum

Correct answer: A

Rationale: In chronic obstructive pulmonary disease (COPD), clients often develop a barrel chest, characterized by an increased anterior-posterior diameter of the chest due to hyperinflation of the lungs. This change in chest shape is a common finding in COPD. Decreased respiratory rate, weight gain, and productive cough with yellow sputum are not typical findings associated with COPD.

2. A client with asthma is taking fluticasone. The nurse should monitor the client for which of the following adverse effects?

• A. Hypoglycemia
• B. Hypertension
• C. Polyuria
• D. Oral candidiasis

Correct answer: D

Rationale: Fluticasone is a corticosteroid often used to manage asthma. One of the common adverse effects associated with inhaled corticosteroids like fluticasone is oral candidiasis, also known as thrush. This fungal infection can develop in the mouth and throat due to the steroid's local immunosuppressive effects. Patients should be advised to rinse their mouths after using inhaled corticosteroids to reduce the risk of oral candidiasis. Monitoring for symptoms such as white patches, sore throat, or difficulty swallowing is essential to detect and manage this adverse effect promptly.

3. A healthcare professional is assessing a client with rheumatoid arthritis. Which assessment finding is most characteristic of this disease?

• A. Asymmetrical joint involvement
• B. Heberden's nodes
• C. Morning stiffness lasting more than 30 minutes
• D. Pain that worsens with activity

Correct answer: C

Rationale: Morning stiffness lasting more than 30 minutes is a hallmark symptom of rheumatoid arthritis. This prolonged morning stiffness is typically a distinguishing feature of rheumatoid arthritis compared to other types of arthritis, making it the most characteristic assessment finding for this disease.

4. A nurse is assessing a client who has COPD. The nurse should expect the client's chest to be which of the following shapes?

• A. Pigeon
• B. Funnel
• C. Kyphotic
• D. Barrel

Correct answer: D

Rationale:

5. A client with tuberculosis (TB) is taking isoniazid (INH). Which instruction is most important for the nurse to include?

• A. Take the medication with food to avoid stomach upset.
• B. Avoid exposure to sunlight while taking this medication.
• C. Report any numbness or tingling in extremities.
• D. Have liver function tests done regularly.

Correct answer: D

Rationale: Regular monitoring of liver function tests is crucial for clients taking isoniazid (INH) due to the potential risk of hepatotoxicity. Isoniazid can cause liver damage, and early detection through routine liver function tests can help prevent severe complications.

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