Nursing Elites

1. A client is being instructed on how to perform pursed-lip breathing. Which of the following should be included in the plan of care?

• A. Take quick breaths upon inhalation.
• B. Place your hand over your stomach.
• C. Take a deep breath in through your nose.
• D. Puff your cheeks upon exhalation.

Correct answer: C

Rationale: Pursed-lip breathing is a breathing technique that involves inhaling slowly through the nose and exhaling gently through pursed lips. This technique helps improve breathing efficiency and can be beneficial for individuals with respiratory conditions. Instructing the client to take a deep breath in through the nose is essential for proper execution of pursed-lip breathing, making choice C the correct answer.

2. What is the best description of resonance?

• A. Sounds created by air-filled structures
• B. Short, high-pitched, and thudding
• C. Moderately loud with a musical quality
• D. Drum-like

Correct answer: A

Rationale: Resonance refers to the quality of sound produced by vibrations that are reinforced by other vibrations of the same frequency. In the context of the human body, resonance is often associated with sounds produced by air-filled structures like the lungs, vocal cords, and resonating cavities. Therefore, the best description of resonance from the given options is 'Sounds created by air-filled structures.' This choice aligns with the concept of resonance as it relates to sound production in the human body. Choices B, C, and D are incorrect as they do not specifically relate to the concept of resonance or its association with air-filled structures.

3. When a client is comatose and has advance directives stating a desire to avoid life-sustaining measures, but the family wants these measures, what action should the nurse take?

• A. Arrange for an ethics committee meeting to address the family's concerns.
• B. Support the family's decision and initiate life-sustaining measures.
• C. Complete an incident report.
• D. Encourage the family to contact an attorney.

Correct answer: A

Rationale: In this scenario, the nurse should prioritize the client's wishes as outlined in the advance directives. By arranging for an ethics committee meeting, the nurse can facilitate discussions between the family and healthcare team to ensure that the client's wishes are respected while addressing the concerns of the family. This approach promotes ethical decision-making and collaborative communication among all involved parties, ultimately aiming to provide the best possible care for the client while considering their autonomy and preferences.

4. A public health nurse is managing several projects for the community. Which of the following interventions should the nurse identify as a primary prevention strategy?

• A. Teaching parenting skills to expectant mothers and their partners.
• B. Conducting mental health screenings at the local community center
• C. Referring clients with obesity to community exercise programs
• D. Providing crisis intervention through a mobile counseling unit

Correct answer: A

Rationale: The correct answer is teaching parenting skills to expectant mothers and their partners. This intervention is a primary prevention strategy aimed at educating individuals before a problem or condition develops. By teaching parenting skills, the nurse is promoting healthy behaviors and relationships, which can prevent future issues. The other options involve secondary or tertiary prevention strategies by identifying and treating existing conditions or providing interventions after a problem has occurred.

5. A client is receiving vecuronium for acute respiratory distress syndrome. Which of the following medications should the nurse anticipate administering with this medication?

• A. Fentanyl
• B. Furosemide
• C. Famotidine
• D. Dexamethasone

Correct answer: A

Rationale: Vecuronium is a neuromuscular blocking agent used for muscle relaxation during mechanical ventilation. When administering vecuronium, it is common to also give an opioid analgesic, such as fentanyl, to manage pain and ensure the patient's comfort. Fentanyl is often used in combination with neuromuscular blocking agents to provide balanced anesthesia, making it the appropriate medication to anticipate administering in this scenario.

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