Nursing Elites

1. What information should be included as effective for preventing chronic bronchitis in a community presentation?

• A. Maintenance of ideal weight
• B. Annual influenza immunization
• C. Smoking cessation
• D. Regular moderate exercise

Correct answer: C

Rationale: Chronic bronchitis is often linked to smoking. Smoking cessation is the most effective preventive measure to reduce the risk of developing chronic bronchitis. Smoking damages the airways and leads to inflammation, making individuals more susceptible to chronic bronchitis. While maintaining an ideal weight, getting an annual influenza vaccine, and engaging in regular moderate exercise are beneficial for overall health, the most crucial intervention to prevent chronic bronchitis is quitting smoking.

2. A client is 12 hours postoperative and has a chest tube to a disposable water-seal drainage system with suction. The healthcare provider should intervene for which of the following observations?

• A. Constant bubbling in the suction-control chamber
• B. Continuous bubbling in the water-seal chamber
• C. Bloody drainage in the collection chamber
• D. Fluid-level fluctuations in the water-seal chamber

Correct answer: B

Rationale: Continuous bubbling in the water-seal chamber indicates an air leak, which can compromise the system's integrity and affect the client's respiratory status. The other options are expected findings in a client with a chest tube drainage system: constant bubbling in the suction-control chamber indicates proper suction function, bloody drainage in the collection chamber is expected in the immediate postoperative period, and fluid-level fluctuations in the water-seal chamber demonstrate normal drainage and lung re-expansion.

3. A client has an oxygen saturation of 88% on room air. Which action should the nurse take first?

• A. Initiate oxygen therapy at 2 liters per minute via nasal cannula.
• B. Place the client in a high-Fowler's position.
• C. Notify the healthcare provider.
• D. Document the finding in the client's medical record.

Correct answer: A

Rationale: The priority action for a client with an oxygen saturation of 88% on room air is to initiate oxygen therapy to improve oxygen saturation levels. Oxygen therapy is crucial to address hypoxemia promptly. Placing the client in a high-Fowler's position can also aid in oxygenation, but administering oxygen takes precedence. While notifying the healthcare provider is important, it is a secondary action after ensuring the client's immediate need for oxygen is met. Documenting the finding in the client's medical record is necessary for continuity of care but is not the primary intervention when addressing hypoxemia.

4. Prior to performing percussion, vibration, and postural drainage on an adolescent client with pneumonia, which of the following nursing actions should the nurse complete first?

• A. Auscultate lung fields
• B. Assess pulse and respirations
• C. Assess characteristics of the sputum
• D. Instruct the client to slowly exhale with pursed lips

Correct answer: A

Rationale: Before initiating percussion, vibration, and postural drainage, the nurse should first auscultate the lung fields to assess the baseline lung sounds and identify areas of congestion or abnormality. This initial assessment helps the nurse to tailor the percussion and drainage techniques effectively. Assessing pulse and respirations, sputum characteristics, and providing instructions to the client for exhalation are important steps in the procedure but should follow the initial auscultation to ensure a comprehensive and individualized care approach.

5. A healthcare professional is assessing a client who is recovering from a lung biopsy. Which assessment finding requires immediate action?

• A. Increased temperature
• B. Absent breath sounds
• C. Productive cough
• D. Incisional discomfort

Correct answer: B

Rationale: Absent breath sounds may indicate a pneumothorax, a serious complication post lung biopsy. This condition requires immediate attention to prevent respiratory distress.

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