Nursing Elites

1. A client is being admitted to the surgical unit from the PACU following a cholecystectomy. Which of the following assessments is the nurse's priority?

• A. Bowel sounds
• B. Surgical dressing
• C. Temperature
• D. Oxygen saturation

Correct answer: D

Rationale: The priority assessment for a client being admitted to the surgical unit following a cholecystectomy is oxygen saturation. Monitoring oxygen saturation is crucial to ensure adequate oxygenation and ventilation, especially after surgery. Hypoxia can have serious consequences and needs to be promptly addressed. While assessing bowel sounds, surgical dressing, and temperature are important, oxygen saturation takes precedence in this situation.

2. A client in a clinic presents with an acute asthma exacerbation. Which of the following medications should reduce the symptoms?

• A. Cromolyn via a metered-dose inhaler
• B. Montelukast orally
• C. Budesonide via a dry-powder inhaler
• D. Albuterol via a jet nebulizer

Correct answer: D

Rationale: During an acute asthma exacerbation, the preferred medication for symptom relief is a short-acting beta-agonist like albuterol, typically delivered via a jet nebulizer for quick onset and efficacy. Cromolyn, montelukast, and budesonide are not as effective for immediate symptom relief in acute exacerbations and are more commonly used for prevention or long-term management of asthma symptoms.

3. A client is wearing a Venturi mask to receive oxygen, and the dinner tray has arrived. What action by the nurse is best?

• A. Assess the client's oxygen saturation and, if normal, turn off the oxygen.
• B. Determine if the client can switch to a nasal cannula during the meal.
• C. Have the client lift the mask off the face when taking bites of food.
• D. Turn off the oxygen while the client eats the meal and then restart it.

Correct answer: B

Rationale: In this scenario, the nurse should determine if the client can safely switch to a nasal cannula during meals. It is crucial to ensure that the provider has approved this change. Oxygen is considered a medication and should be delivered continuously. Turning off the oxygen or lifting the mask while eating can lead to a decrease in the FiO2 delivered, potentially compromising the client's oxygenation status. Therefore, the best course of action is to ascertain if transitioning to a nasal cannula is appropriate for the client during the meal.

4. A client with a long history of smoking is being assessed by a nurse. Which finding is a common complication of chronic obstructive pulmonary disease (COPD)?

• A. Decreased anteroposterior chest diameter
• B. Increased breath sounds
• C. Prolonged expiratory phase
• D. Increased chest expansion

Correct answer: C

Rationale: In COPD, a prolonged expiratory phase is a typical finding caused by airway obstruction and air trapping. This results in difficulty expelling air from the lungs, leading to the characteristic prolonged exhalation in individuals with COPD.

5. A nurse is assessing a client for a suspected anaphylactic reaction following a CT scan with contrast media. For which of the following client findings should the nurse intervene first?

• A. Urticaria
• B. Stridor
• C. Vomiting
• D. Hypotension

Correct answer: B

Rationale:

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