Nursing Elites

1. A nurse is providing discharge instructions to a client with chronic obstructive pulmonary disease (COPD). What instruction should the nurse include to help improve oxygenation?

• A. Avoid physical activity
• B. Use pursed-lip breathing during activities
• C. Limit sun exposure
• D. Perform weight-bearing exercises

Correct answer: B

Rationale: The correct answer is B: 'Use pursed-lip breathing during activities.' Pursed-lip breathing improves oxygenation by keeping airways open longer, facilitating better exhalation of carbon dioxide. Choice A is incorrect because avoiding physical activity can lead to deconditioning and worsen oxygenation. Choice C is irrelevant to improving oxygenation in COPD. Choice D is not directly related to improving oxygenation in COPD; weight-bearing exercises are important for bone health but not for oxygenation.

2. A healthcare professional is reviewing the lab results of a client who has been experiencing a fever for 3 days. What finding indicates fluid volume deficit (FVD)?

• A. Decreased hematocrit
• B. Increased white blood cell count
• C. Increased hematocrit
• D. Decreased white blood cell count

Correct answer: C

Rationale: Increased hematocrit indicates hemoconcentration, which is a sign of fluid volume deficit. In FVD, there is a loss of fluid without a proportional loss of electrolytes, leading to hemoconcentration. Choices A, B, and D are incorrect. Decreased hematocrit and decreased white blood cell count are not typical findings in fluid volume deficit. An increased white blood cell count is more indicative of infection or inflammation rather than fluid volume deficit.

3. A nurse is preparing to perform a focused respiratory assessment on a client with COPD. What is an expected finding?

• A. Normal respiratory rate
• B. Nasal flaring
• C. Decreased breath sounds
• D. Increased breath sounds

Correct answer: B

Rationale: Nasal flaring is an expected finding in clients with COPD who are experiencing respiratory distress. Nasal flaring is a sign of increased work of breathing and respiratory distress, commonly seen in clients with COPD exacerbation. Choices A, C, and D are incorrect. A normal respiratory rate would not be an expected finding in a client with COPD, as they often have an increased respiratory rate. Decreased breath sounds could indicate diminished airflow but are not typically a common finding in COPD. Increased breath sounds are not typical in COPD and could indicate other conditions like pneumonia.

4. A nurse is teaching a client with diabetes mellitus about foot care. What is the most important instruction the nurse should include?

• A. Apply lotion between the toes after bathing
• B. Inspect feet daily for injuries
• C. Wear shoes only indoors
• D. Cut toenails in a rounded shape

Correct answer: B

Rationale: Inspecting feet daily for injuries is crucial for clients with diabetes to prevent unnoticed wounds from becoming infected. This instruction is the most important as it helps in early detection and management of foot problems. Choice A is incorrect because applying lotion between the toes can lead to excessive moisture, increasing the risk of fungal infections. Choice C is wrong as wearing shoes indoors can also lead to foot issues. Choice D is incorrect because cutting toenails in a rounded shape can result in ingrown toenails, posing a risk for infection.

5. A client is found on the floor experiencing a seizure. What is the nurse's priority action?

• A. Apply oxygen
• B. Place the client on their side
• C. Administer an anticonvulsant
• D. Notify the provider

Correct answer: B

Rationale: The nurse's priority action when finding a client experiencing a seizure is to place the client on their side. This action helps maintain an open airway and prevents aspiration, which is crucial during a seizure. Applying oxygen may be necessary after ensuring a patent airway, while administering an anticonvulsant is not within the nurse's scope of practice during an acute seizure. Notifying the provider can be done after ensuring the client's immediate safety.

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