Nursing Elites

1. A nurse cares for a client with chronic obstructive pulmonary disease who has been prescribed continuous oxygen therapy at home. Which statement indicates the client correctly understands the teaching?

• A. I plan to wear my oxygen when I exercise & feel short of breath.
• B. I will use my portable oxygen when grilling burgers in the backyard.
• C. I plan to use cotton balls to cushion the oxygen tubing on my ears.
• D. I will only smoke while I am wearing my oxygen via nasal cannula.

Correct answer: C

Rationale: Cotton balls can decrease pressure ulcers from the oxygen tubing. Continuous oxygen orders mean the client should wear the oxygen at all times. Oxygen fuels a fire. Wearing oxygen while grilling & smoking increases the risk for fire.

2. A client with chronic obstructive pulmonary disease (COPD) is receiving nutrition education. Which nutrition information should the nurse include in this client's teaching? (Select ONE that does not apply)

• A. Avoid drinking fluids just before and during meals.
• B. Rest before meals if you have dyspnea.
• C. Have about six small meals a day.
• D. Eat high-fiber foods to promote gastric emptying.

Correct answer: D

Rationale: The correct answer is D. Avoiding drinking fluids just before and during meals helps prevent bloating in clients with COPD. Resting before meals if experiencing dyspnea can aid in improving breathing during meals. Having approximately six small meals a day can reduce bloating and help with easier digestion. However, consuming high-fiber foods to promote gastric emptying is not advisable for clients with COPD, as fibrous foods can lead to gas production, abdominal bloating, and increased shortness of breath. Clients with COPD should focus on increasing calorie and protein intake to prevent malnourishment. Increasing carbohydrate intake should also be avoided, as it can raise carbon dioxide production and worsen dyspnea.

3. A client reports a headache and vertigo after turning on his furnace for the first time this season. The nurse should suspect which of the following conditions?

• A. Carbon monoxide poisoning
• B. Heat stroke
• C. Hypersensitivity reaction
• D. Oxygen toxicity

Correct answer: A

Rationale: When a client reports headache and vertigo after turning on the furnace for the first time, it suggests carbon monoxide poisoning. Carbon monoxide is an odorless, colorless gas that can be released by malfunctioning heating systems. Symptoms of carbon monoxide poisoning include headache, dizziness, weakness, nausea, and confusion. It is crucial for the nurse to suspect this condition promptly to ensure the client's safety and well-being.

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. When preparing a client for transfer to the ICU for placement of a pulmonary artery catheter, the nurse should explain that this catheter is used to monitor which of the following conditions?

• A. Intracranial pressure
• B. Spinal cord perfusion
• C. Renal function
• D. Hemodynamic status

Correct answer: D

Rationale: A pulmonary artery catheter is primarily used to monitor hemodynamic status. It provides essential information on cardiac output, preload, afterload, and overall cardiovascular function. This data helps healthcare providers manage the client's fluid status, cardiac function, and guide treatment interventions in critically ill patients. Monitoring intracranial pressure, spinal cord perfusion, or renal function would require different monitoring devices and techniques, not a pulmonary artery catheter.

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