Nursing Elites

1. A nurse is planning care for a client who has chronic obstructive pulmonary disease (COPD). Which of the following actions should the nurse take?

• A. Encourage the client to increase physical activity.
• B. Place the client in the Trendelenburg position.
• C. Limit the client's fluid intake to prevent fluid overload.
• D. Administer high-flow oxygen via mask.

Correct answer: A

Rationale: The correct action for the nurse to take when caring for a client with COPD is to encourage the client to increase physical activity. Increased physical activity helps manage COPD symptoms by improving lung function and preventing deconditioning. Placing the client in the Trendelenburg position is not recommended for COPD as it can worsen breathing difficulties. Limiting fluid intake to prevent fluid overload is not typically necessary in COPD unless the client has comorbid conditions that require fluid restriction. Administering high-flow oxygen via mask may be necessary for COPD clients with severe hypoxemia, but it is not the initial action for planning care.

2. What is the appropriate nursing response when a patient refuses blood transfusion due to religious beliefs?

• A. Respect the patient's decision and notify the provider
• B. Attempt to persuade the patient to accept the transfusion
• C. Document the refusal and notify the healthcare provider
• D. Provide education on the benefits of blood transfusion

Correct answer: A

Rationale: The correct answer is A: "Respect the patient's decision and notify the provider." When a patient refuses a blood transfusion due to religious beliefs, it is essential to respect their autonomy and religious beliefs. Attempting to persuade the patient (Choice B) goes against the principle of respect for autonomy and can lead to ethical dilemmas. Documenting the refusal and notifying the healthcare provider (Choice C) is important for legal and ethical purposes but should be preceded by respecting the patient's decision. Providing education on the benefits of blood transfusion (Choice D) may be appropriate in other situations but is not indicated when a patient refuses based on religious beliefs.

3. A healthcare provider is teaching a client who has a new diagnosis of hypertension about dietary management. Which of the following foods should the healthcare provider instruct the client to avoid?

• A. Bananas
• B. Carrots
• C. Bacon
• D. Chicken breast

Correct answer: C

Rationale: The correct answer is C. Bacon is high in sodium, which can elevate blood pressure levels. Clients with hypertension should avoid high-sodium foods like bacon to help manage their blood pressure. Choices A, B, and D are healthier options compared to bacon and can be included in a balanced diet for someone with hypertension. Bananas are a good source of potassium, which can help in managing blood pressure. Carrots are low in sodium and high in fiber, making them a heart-healthy choice. Chicken breast is a lean protein option that is beneficial for individuals with hypertension.

4. A nurse is preparing to administer digoxin to a client who has heart failure. Which of the following findings should the nurse report to the provider?

• A. Potassium 4.0 mEq/L
• B. Calcium 9.5 mg/dL
• C. Heart rate of 60/min
• D. Sodium 140 mEq/L

Correct answer: C

Rationale: The correct answer is C: Heart rate of 60/min. A heart rate of 60/min is borderline bradycardia, which can be a sign of digoxin toxicity. Digoxin can cause bradycardia, so any further decrease in heart rate should be reported promptly to the healthcare provider. Choices A, B, and D are within the normal range and not specifically related to potential digoxin toxicity, so they do not require immediate reporting.

5. A nurse is caring for a client who has diabetes insipidus. Which of the following findings should the nurse expect?

• A. Weight gain
• B. Increased urine output
• C. Bradycardia
• D. Hyperactive bowel sounds

Correct answer: B

Rationale: Increased urine output is a key finding in clients with diabetes insipidus due to a deficiency of antidiuretic hormone. Weight gain (choice A) is not expected in diabetes insipidus as it is a condition characterized by excessive thirst and urination leading to fluid loss. Bradycardia (choice C) and hyperactive bowel sounds (choice D) are not typically associated with diabetes insipidus.

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