Nursing Elites

1. A client who is at 32 weeks gestation and has a history of cardiac disease is being cared for by a nurse. Which of the following positions should the nurse place the client in to best promote optimal cardiac output?

• A. The chest
• B. Standing
• C. Supine
• D. Left lateral

Correct answer: D

Rationale: The correct answer is the left lateral position. Placing the client in the left lateral position promotes optimal cardiac output during pregnancy by reducing pressure on the inferior vena cava, improving blood flow to the heart and fetus. Choice A, 'The chest,' is incorrect as it does not describe a position that benefits cardiac output. Choice B, 'Standing,' is incorrect as it does not alleviate pressure on the vena cava. Choice C, 'Supine,' is contraindicated in pregnancy, especially in clients with cardiac disease, as it can compress the vena cava and decrease cardiac output.

2. What teaching points are important for the nurse to discuss with a client with hearing loss who has been fitted for a hearing aid?

• A. Use the highest setting to promote full auditory comprehension
• B. Use mild soap and water to clean the ear mold
• C. Turn the hearing aid off to conserve battery life during hours of sleep only
• D. Immerse the hearing aid in saline solution to keep it hygienic

Correct answer: B

Rationale: The correct teaching point for a client with hearing loss who has been fitted for a hearing aid is to use mild soap and water to clean the ear mold. It is important to keep the ear mold clean to prevent infections and maintain proper functioning. Choice A is incorrect because using the highest setting can lead to discomfort and may not be necessary for all situations. Choice C is incorrect as the hearing aid should generally be turned off when not in use, not just during sleep, to conserve battery life. Choice D is incorrect as immersing the hearing aid in saline solution can damage the device; it should be kept dry to prevent malfunction.

3. Which of the following characteristics would indicate true labor in a client?

• A. Contractions are irregular and painless
• B. Fetus moves to an anterior position
• C. Bloody show is not present
• D. Contractions are regular in frequency

Correct answer: D

Rationale: The correct answer is D. True labor is characterized by regular contractions that increase in intensity and frequency. These contractions lead to cervical dilation and effacement, signaling the onset of labor. Choice A is incorrect because true labor contractions are regular and painful, not irregular and painless. Choice B is irrelevant to determining true labor. Choice C is also unrelated as the presence or absence of a bloody show does not definitively indicate true labor.

4. A nurse is caring for a client with Alzheimer's disease. Which action should the nurse include in the care plan to support the client’s cognitive function?

• A. Place a daily calendar in the kitchen
• B. Replace buttoned clothing with zippered items
• C. Replace carpet with hardwood floors
• D. Create variation in the daily routine

Correct answer: A

Rationale: Placing a daily calendar in the kitchen is beneficial for clients with Alzheimer's disease as it helps in orienting them to time and enhances cognitive function. This visual aid can assist in keeping track of days and activities. Choice B, replacing buttoned clothing with zippered items, is more related to promoting independence in dressing rather than directly supporting cognitive function. Choice C, replacing carpet with hardwood floors, focuses on safety and mobility rather than cognitive function. Choice D, creating variation in the daily routine, may be helpful for engagement and stimulation but does not directly address cognitive function as effectively as using a daily calendar.

5. A healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD) receiving oxygen therapy. Which of the following findings indicates oxygen toxicity?

• A. Oxygen saturation 94%
• B. Decreased respiratory rate
• C. Wheezing
• D. Peripheral cyanosis

Correct answer: B

Rationale: The correct answer is B: Decreased respiratory rate. In clients with COPD, especially when receiving oxygen therapy, a decreased respiratory rate is indicative of oxygen toxicity. This occurs because their respiratory drive is often dependent on low oxygen levels. Oxygen saturation of 94% is within an acceptable range and does not necessarily indicate oxygen toxicity. Wheezing is more commonly associated with airway narrowing or constriction, while peripheral cyanosis is a sign of decreased oxygen levels in the peripheral tissues, not oxygen toxicity.

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