Nursing Elites

1. A healthcare provider assesses a client with pneumonia. Which clinical manifestation should the provider expect to find?

• A. Fremitus
• B. Hyperresonance
• C. Dullness on percussion
• D. Decreased tactile fremitus

Correct answer: C

Rationale: Pneumonia often leads to the consolidation of lung tissue, resulting in dullness on percussion. This occurs due to the presence of fluid or inflammatory material in the alveoli. Fremitus and decreased tactile fremitus are more indicative of conditions like pleural effusion or pneumothorax, where there is an increase in the density of the pleural space or air in the pleural cavity. Hyperresonance, on the other hand, is typically associated with conditions causing air trapping, such as emphysema, where there is increased air in the alveoli.

2. When prioritizing client care after receiving change-of-shift report, which of the following clients should the nurse plan to see first?

• A. A client who is scheduled for an abdominal x-ray and is awaiting transport
• B. A client who has a prescription for discharge
• C. A client who received oral pain medication 30 minutes ago
• D. A client who told an assistive personnel he is short of breath

Correct answer: D

Rationale: When a client expresses being short of breath, it may indicate a serious condition requiring immediate attention to ensure adequate oxygenation. This client should be seen first to assess the severity of the situation and initiate appropriate interventions. The other options, such as awaiting transport for an x-ray, having a prescription for discharge, or receiving oral pain medication 30 minutes ago, do not present immediate life-threatening concerns compared to a client experiencing shortness of breath.

3. How does the pain of a myocardial infarction (MI) differ from stable angina?

• A. Accompanied by shortness of breath
• B. Feelings of fear or anxiety
• C. Lasts less than 15 minutes
• D. No relief from taking nitroglycerin

Correct answer: C

Rationale: The pain of a myocardial infarction (MI) is often accompanied by shortness of breath and feelings of fear or anxiety. Unlike stable angina, the pain of an MI typically lasts longer than 15 minutes and is not relieved by nitroglycerin. Additionally, it can occur without a known cause, unlike stable angina which often has a trigger such as exertion.

4. A client with newly diagnosed osteoporosis is being taught about lifestyle modifications. Which instruction should be included?

• A. Increase intake of caffeinated beverages.
• B. Engage in weight-bearing exercises regularly.
• C. Avoid exposure to sunlight.
• D. Take calcium supplements with iron.

Correct answer: B

Rationale: Engaging in weight-bearing exercises is crucial for individuals with osteoporosis as it helps strengthen bones and reduce the risk of fractures. Weight-bearing exercises include activities like walking, jogging, dancing, and strength training. These exercises help improve bone density and overall bone health, making them an essential component of lifestyle modifications for individuals with osteoporosis.

5. A client is 12 hours postoperative and has a chest tube to a disposable water-seal drainage system with suction. The healthcare provider should intervene for which of the following observations?

• A. Constant bubbling in the suction-control chamber
• B. Continuous bubbling in the water-seal chamber
• C. Bloody drainage in the collection chamber
• D. Fluid-level fluctuations in the water-seal chamber

Correct answer: B

Rationale: Continuous bubbling in the water-seal chamber indicates an air leak, which can compromise the system's integrity and affect the client's respiratory status. The other options are expected findings in a client with a chest tube drainage system: constant bubbling in the suction-control chamber indicates proper suction function, bloody drainage in the collection chamber is expected in the immediate postoperative period, and fluid-level fluctuations in the water-seal chamber demonstrate normal drainage and lung re-expansion.

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