Nursing Elites

1. A client in a critical care unit is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed?

• A. Prone
• B. On the nonoperative side
• C. Sims'
• D. Semi-Fowler's

Correct answer: D

Rationale: After a pneumonectomy, positioning the client in a semi-Fowler's position is crucial for optimal ventilation. This position helps improve lung expansion on the remaining side, facilitating better oxygenation and preventing complications like atelectasis. Placing the client prone, on the nonoperative side, or in Sims' position would not provide the same respiratory benefits post-pneumonectomy.

2. During an admission assessment for a client with severe Aspirin toxicity, what finding should the nurse expect?

• A. Body temperature 35°C (95°F)
• B. Lung crackles
• C. Cool, dry skin
• D. Respiratory depression

Correct answer: D

Rationale: In severe Aspirin toxicity, respiratory depression can occur due to increasing respiratory acidosis. Aspirin toxicity leads to metabolic acidosis, stimulating the respiratory center in the brain to increase the respiratory rate initially. However, as the toxicity worsens, respiratory muscle fatigue and depression can occur, resulting in respiratory depression. This can lead to hypoxia, respiratory failure, and ultimately, respiratory arrest.

3. A client has a new prescription for Beclomethasone. Which of the following instructions should the nurse include?

• A. Rinse your mouth after each use of this medication.
• B. Limit fluid intake while taking this medication.
• C. Increase your intake of vitamin B12 while taking this medication.
• D. You can take the medication as needed.

Correct answer: A

Rationale: The correct instruction for a client prescribed Beclomethasone is to rinse the mouth after each use to reduce the risk of oral fungal infection. Beclomethasone is a corticosteroid inhaler that can increase the risk of oral thrush, so rinsing the mouth helps minimize this side effect. Choice B is incorrect because there is no need to limit fluid intake while taking Beclomethasone. Choice C is incorrect as there is no specific need to increase vitamin B12 intake with this medication. Choice D is incorrect because Beclomethasone should be taken as prescribed, not as needed.

4. A client is starting therapy with cisplatin, and a healthcare provider is providing education. Which of the following findings should the healthcare provider instruct the client to report?

• A. Tinnitus
• B. Nausea
• C. Constipation
• D. Weight gain

Correct answer: A

Rationale: The correct answer is A: Tinnitus. The healthcare provider should instruct the client to report tinnitus, as it can be an indication of ototoxicity, an adverse effect associated with cisplatin therapy. Ototoxicity is damage to the inner ear structures that can lead to hearing loss, making it crucial for the client to report any early signs such as tinnitus to prevent further complications. Choices B, C, and D are less concerning in the context of cisplatin therapy. Nausea and constipation are common side effects of cisplatin but are not typically indicative of serious complications requiring immediate reporting. Weight gain is not a typical side effect associated with cisplatin therapy and is less likely to be related to the medication.

5. A healthcare provider is caring for four clients who have Peptic Ulcer Disease. The healthcare provider should recognize Misoprostol is contraindicated for which of the following clients?

• A. A client who is pregnant
• B. A client who has osteoarthritis
• C. A client who has a kidney stone
• D. A client who has a urinary tract infection

Correct answer: A

Rationale: Misoprostol is contraindicated in pregnancy due to its potential to induce labor. It is used to prevent ulcers in patients taking nonsteroidal anti-inflammatory drugs and is not indicated for osteoarthritis, kidney stones, or urinary tract infections. Therefore, the correct answer is A. Misoprostol should not be used in pregnant individuals as it can cause uterine contractions and potentially harm the fetus. Choices B, C, and D are incorrect as Misoprostol is not contraindicated for clients with osteoarthritis, kidney stones, or urinary tract infections.

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