Nursing Elites

1. A nurse is caring for a client who had a stroke and is showing signs of dysphagia. Which of the following findings should the nurse recognize as an indication of this condition?

• A. Abnormal movements of the mouth
• B. Inability to stand without assistance
• C. Paralysis of the right arm
• D. Loss of appetite

Correct answer: A

Rationale: Abnormal movements of the mouth are a common indication of dysphagia, a condition that impairs swallowing function. In clients who have had a stroke, dysphagia can increase the risk of aspiration, leading to serious complications. Inability to stand without assistance (Choice B) is more indicative of motor deficits following a stroke rather than dysphagia. Paralysis of the right arm (Choice C) is a manifestation of hemiplegia, which is common in stroke but not directly related to dysphagia. Loss of appetite (Choice D) may occur in individuals with dysphagia but is not a direct indicator of the condition itself.

2. A nurse is teaching a client about the use of a metered-dose inhaler (MDI). Which instruction should the nurse include in the teaching?

• A. Inhale the medication deeply for 3-5 seconds
• B. Exhale forcefully before inhaling
• C. Shake the MDI vigorously before use
• D. Hold the mouthpiece 2.5-5 cm (1-2 in) in front of the mouth

Correct answer: A

Rationale: Corrected Rationale: Inhaling the medication deeply for 3-5 seconds and holding the breath for 10 seconds after inhalation ensures effective medication delivery to the lungs. Choice A is the correct instruction for the use of a metered-dose inhaler (MDI). Choice B, exhaling forcefully before inhaling, is incorrect as it can lead to decreased medication delivery. Choice C, shaking the MDI vigorously before use, is also incorrect as excessive shaking can cause the medication to clump. Choice D, holding the mouthpiece 2.5-5 cm (1-2 in) in front of the mouth, is not recommended as it may lead to improper inhalation technique.

3. A nurse is assessing a client for signs of deep vein thrombosis (DVT). Which of the following findings should the nurse look for?

• A. Swelling in the limb
• B. Decreased heart rate
• C. Increased appetite
• D. Improved mobility

Correct answer: A

Rationale: The correct answer is A: Swelling in the limb. Swelling, particularly in one limb, is a common sign of deep vein thrombosis (DVT) and should be assessed. This swelling is often accompanied by pain, redness, and warmth in the affected area. Choices B, C, and D are incorrect because decreased heart rate, increased appetite, and improved mobility are not typically associated with DVT. The main focus in assessing for DVT is recognizing the signs and symptoms related to venous thrombosis.

4. A nurse in an urgent-care clinic is collecting admission history from a client who is 16 weeks gestation and has bacterial vaginosis. The nurse should recognize that which of the following clinical findings are associated with this infection?

• A. Frequency and dysuria
• B. Profuse milky white discharge
• C. Hematuria
• D. Low-grade fever

Correct answer: B

Rationale: Bacterial vaginosis often presents with a profuse, milky white discharge and a characteristic fishy odor, without significant inflammation, hematuria, or fever. Choice A, frequency, and dysuria are more indicative of a urinary tract infection. Choice C, hematuria, is associated with conditions like urinary tract infections or kidney problems. Choice D, low-grade fever, is not a typical symptom of bacterial vaginosis.

5. A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription?

• A. Asthma
• B. Hypertension
• C. Tachydysrhythmias
• D. Urolithiasis

Correct answer: A

Rationale: Corrected Rationale: Propranolol, a non-selective beta-blocker, should be avoided in clients with asthma as it can cause bronchoconstriction due to its beta2-blocking effects. Therefore, a client history finding of asthma would require the nurse to clarify this medication prescription. Hypertension, tachydysrhythmias, and urolithiasis are not contraindications for propranolol use, making them incorrect choices. For clients with asthma, a beta1 selective blocker would be preferred to avoid exacerbating bronchoconstriction.

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