Nursing Elites

1. A healthcare provider is caring for a group of clients. Which of the following clients is not at risk for pulmonary embolism?

• A. A client who has a BMI of 30
• B. A female client who is postmenopausal
• C. A client who has a fractured femur
• D. A client who has chronic atrial fibrillation

Correct answer: A female client who is postmenopausal

Rationale: Postmenopausal status is not a significant risk factor for pulmonary embolism. Risk factors for pulmonary embolism include obesity (BMI of 30 or higher), immobility such as having a fractured femur, and conditions like chronic atrial fibrillation that increase the risk of blood clot formation. While postmenopausal status may be associated with other health risks, it is not directly linked to an increased risk of pulmonary embolism.

2. A healthcare professional is reviewing ABG laboratory results of a client who is in respiratory distress. The results are pH 7.47, PaCO2 32 mm Hg, and HCO3 22 mm Hg. The healthcare professional should recognize that the client is experiencing which of the following acid-base imbalances?

• A. Respiratory acidosis
• B. Respiratory alkalosis
• C. Metabolic acidosis
• D. Metabolic alkalosis

Correct answer: Respiratory alkalosis

Rationale: The ABG results show a high pH (alkalosis) along with low PaCO2 and normal HCO3 levels, indicating respiratory alkalosis. In this condition, there is excessive loss of carbon dioxide (as seen by the low PaCO2) leading to a decrease in carbonic acid concentration and subsequent increase in pH. Metabolic acidosis or alkalosis would involve primary changes in bicarbonate levels, which are not predominant in this case.

3. During an assessment, a healthcare provider observes a client with a chest tube and drainage system. What is an expected finding?

• A. Continuous bubbling in the water seal chamber
• B. Gentle constant bubbling in the suction control chamber
• C. Drainage system positioned upright at chest level
• D. Exposed sutures without dressing

Correct answer: Gentle constant bubbling in the suction control chamber

Rationale: When assessing a client with a chest tube and drainage system, gentle constant bubbling in the suction control chamber is an expected finding. This indicates that the system is functioning properly. Continuous bubbling in the water seal chamber would suggest an air leak, the drainage system should be positioned upright at chest level to promote proper drainage, and exposed sutures without dressing would be an incorrect finding as they should be covered to prevent infection.

4. When discussing group treatment and therapy with a client, which characteristic should the nurse include as being a characteristic of a therapeutic group?

• A. The group is organized in an autocratic structure.
• B. The group encourages members to focus on a particular issue
• C. The group must be led by a licensed psychiatrist.
• D. The group encourages clients to form dependent relationships.

Correct answer: The group encourages members to focus on a particular issue

Rationale: In therapeutic groups, the focus is often on addressing specific issues or topics. This approach allows group members to concentrate on their concerns, share experiences, and work towards common goals. Autocratic structures, mandatory leadership by a licensed psychiatrist, or fostering dependent relationships are not typical characteristics of therapeutic groups.

5. The healthcare professional prepares to administer buccal medication. The medicine should be placed...

• A. On the client's skin
• B. Between the client's cheeks and gums
• C. Under the client's tongue
• D. On the client's conjunctiva

Correct answer: B

Rationale: Buccal medication is administered by placing it between the client's cheeks and gums. This route allows for the medication to be absorbed through the mucous membranes in the mouth, providing a rapid onset of action compared to oral ingestion. Placing the medication under the tongue (sublingual) allows for absorption through the sublingual mucosa, not the buccal mucosa. Placing medication on the skin or the conjunctiva is not appropriate for buccal administration.

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