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. A client in the late stage of inhalation anthrax requires a plan of care. What is appropriate to include in the plan of care?

• A. Provide respiratory support.
• B. Place the client in droplet isolation.
• C. Administer antihypertensive medications.
• D. Monitor ascites.

Correct answer: A

Rationale: In the late stage of inhalation anthrax, respiratory support is crucial due to the potential for respiratory failure. Providing oxygen therapy and maintaining airway patency are essential components of care to improve oxygenation and support respiratory function. Placing the client in droplet isolation is not necessary as inhalation anthrax is not transmitted from person to person through respiratory droplets. Administering antihypertensive medications is not indicated in the treatment of inhalation anthrax. Monitoring for ascites is not a priority in the late stage of inhalation anthrax.

3. What information should be included as effective for preventing chronic bronchitis in a community presentation?

• A. Maintenance of ideal weight
• B. Annual influenza immunization
• C. Smoking cessation
• D. Regular moderate exercise

Correct answer: C

Rationale: Chronic bronchitis is often linked to smoking. Smoking cessation is the most effective preventive measure to reduce the risk of developing chronic bronchitis. Smoking damages the airways and leads to inflammation, making individuals more susceptible to chronic bronchitis. While maintaining an ideal weight, getting an annual influenza vaccine, and engaging in regular moderate exercise are beneficial for overall health, the most crucial intervention to prevent chronic bronchitis is quitting smoking.

4. When caring for a client with Alzheimer's disease, what is the most appropriate communication technique for a nurse to use?

• A. Providing detailed explanations
• B. Speaking in a loud and clear voice
• C. Using simple and direct statements
• D. Offering multiple choices to the client

Correct answer: C

Rationale: When communicating with clients with Alzheimer's disease, using simple and direct statements is the most appropriate technique. This approach helps to minimize confusion, enhance understanding, and facilitate effective communication with individuals who may have difficulty processing complex information due to their condition.

5. A nurse collaborates with a respiratory therapist to complete pulmonary function tests (PFTs) for a client. Which statements should the nurse include in communications with the respiratory therapist prior to the tests? (SATA)

• A. I held the client's morning bronchodilator medication.
• B. The client is ready to go down to radiology for this examination.
• C. Physical therapy states the client can run on a treadmill.
• D. I advised the client not to smoke for 6 hours prior to the test.

Correct answer: B

Rationale: To ensure the PFTs are accurate, the therapist needs to know that no bronchodilators have been administered in the past 4 to 6 hours, the client did not smoke within 6 to 8 hours prior to the test and the client can follow basic commands, including different breathing maneuvers. The respiratory therapist can perform PFTs at the bedside. A treadmill is not used for this test.

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