Nursing Elites

1. A client is expressing concern about extreme fatigue following an acute myocardial infarction. What is the best strategy to promote independence?

• A. Instruct the client to rest until fully recovered
• B. Encourage the client to gradually resume self-care tasks with frequent rest periods
• C. Assign assistive personnel to complete self-care tasks
• D. Ask the client's family to assist with self-care

Correct answer: B

Rationale: Encouraging the client to gradually resume self-care tasks with frequent rest periods is the best strategy to promote independence. This approach helps the client regain confidence and autonomy in performing self-care activities. Instructing the client to rest until fully recovered (Choice A) may lead to decreased muscle strength and independence. Assigning assistive personnel (Choice C) does not empower the client to actively participate in their care. Involving the client's family (Choice D) may provide support but does not directly encourage the client's independence.

2. What should the nurse do first when a client with a tracheostomy exhibits respiratory distress?

• A. Notify the provider
• B. Suction the tracheostomy
• C. Administer a bronchodilator
• D. Increase the oxygen flow rate

Correct answer: B

Rationale: The correct initial action when a client with a tracheostomy exhibits respiratory distress is to suction the tracheostomy. This helps to clear secretions and improve the client's ability to breathe. Notifying the provider (choice A) can cause a delay in immediate intervention. Administering a bronchodilator (choice C) may be necessary but is not the priority in this situation. Increasing the oxygen flow rate (choice D) can be helpful but should come after addressing the immediate need for suctioning to clear the airway.

3. What term refers to the agreement to keep promises?

• A. Fidelity
• B. Non-maleficence
• C. Autonomy
• D. Justice

Correct answer: A

Rationale: The term 'fidelity' specifically refers to the agreement to keep promises. Fidelity in healthcare ethics emphasizes the importance of healthcare professionals keeping their commitments to patients. Choice B, 'Non-maleficence,' relates to the ethical principle of doing no harm. Choice C, 'Autonomy,' refers to respecting a patient's right to make decisions about their own healthcare. Choice D, 'Justice,' pertains to fairness and equality in the distribution of healthcare resources.

4. How should a healthcare provider respond to a patient with a suspected pulmonary embolism?

• A. Administer oxygen and call for emergency assistance
• B. Position the patient in a prone position and give fluids
• C. Administer anticoagulants and elevate the patient's legs
• D. Administer thrombolytics and perform chest physiotherapy

Correct answer: A

Rationale: Administering oxygen and calling for emergency assistance are the immediate priorities when managing a suspected pulmonary embolism. Oxygen helps support the patient's respiratory function, while emergency assistance is crucial for further evaluation and treatment. Positioning the patient in a prone position or giving fluids can worsen the condition by impeding blood flow. Administering anticoagulants may be part of the treatment plan but is not the initial response. Thrombolytics and chest physiotherapy are not first-line treatments for suspected pulmonary embolism and can even be harmful without prior evaluation.

5. A client is having difficulty voiding after removal of an indwelling urinary catheter. What should the nurse do?

• A. Assess for bladder distention after 6 hours
• B. Encourage the client to use a bedpan in the supine position
• C. Restrict the client's intake of oral fluids
• D. Pour warm water over the client's perineum

Correct answer: D

Rationale: The correct answer is to pour warm water over the client's perineum. This action helps stimulate voiding post-catheterization by promoting relaxation and providing sensory input. Assessing for bladder distention after 6 hours (Choice A) is important but not the immediate intervention needed for difficulty voiding. Encouraging the client to use a bedpan in the supine position (Choice B) may not effectively address the issue of post-catheterization voiding difficulty. Restricting the client's intake of oral fluids (Choice C) is not appropriate and can lead to dehydration, which is not helpful in promoting voiding.

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