Nursing Elites

1. A client is being educated by a healthcare provider on the purpose of taking a bronchodilator. Which of the following client statements indicates an understanding of the teaching?

• A. ''This medication can decrease my immune response.''
• B. ''I take this medication to prevent asthma attacks.''
• C. ''I need to take this medication with food.''
• D. ''This medication has a slow onset to treat my symptoms.''

Correct answer: B

Rationale: The correct answer is, 'I take this medication to prevent asthma attacks.' Bronchodilators are commonly used to relieve bronchospasm in conditions such as asthma. This medication helps to dilate the airways, making it easier to breathe and preventing asthma attacks. The other options are incorrect: option A is inaccurate as bronchodilators do not decrease immune responses, option C is incorrect as bronchodilators are typically taken on an empty stomach for better absorption, and option D is false as bronchodilators have a rapid onset to provide quick relief of symptoms.

2. Which chamber of the heart receives oxygenated blood from the lungs?

• A. Left atrium
• B. Right atrium
• C. Left ventricle
• D. Right ventricle

Correct answer: A

Rationale: The correct answer is A, the left atrium. The left atrium receives oxygenated blood from the lungs through the pulmonary veins. This blood is then pumped into the left ventricle before being circulated throughout the body. The right atrium, represented by choice B, actually receives deoxygenated blood from the body through the vena cava. Choices C and D, the left ventricle and right ventricle respectively, are chambers involved in pumping blood out of the heart to the body and lungs, rather than receiving blood from the lungs.

3. What is the appropriate needle size for insulin injection?

• A. 18G, 1 ½” long
• B. 22G, 1” long
• C. 22G, 1 ½” long
• D. 25G, 5/8” long

Correct answer: D

Rationale: The appropriate needle size for insulin injection is 25G, 5/8” long. This size allows for accurate and comfortable insulin administration in subcutaneous tissue.

4. A client is being cared for by a nurse 2 hours after admission. The client has an SaO2 of 91%, exhibits audible wheezes, and is using accessory muscles when breathing. Which of the following classes of medication should the nurse expect to administer?

• A. Antibiotic
• B. Beta-blocker
• C. Antiviral
• D. Beta2 agonist

Correct answer: D

Rationale: The client's presentation with an SaO2 of 91%, audible wheezes, and use of accessory muscles indicates respiratory distress, likely due to bronchoconstriction. Beta2 agonists are the appropriate class of medications to administer in this situation as they act as bronchodilators, helping to relieve the bronchoconstriction and improve airflow to the lungs. Antibiotics, beta-blockers, and antivirals are not indicated for this client's respiratory distress symptoms.

5. A patient presents with an exacerbation of chronic obstructive pulmonary disease (COPD) characterized by shortness of breath, orthopnea, thick, tenacious secretions, and a dry hacking cough. An appropriate nursing diagnosis would be:

• A. Ineffective airway clearance related to thick, tenacious secretions.
• B. Ineffective airway clearance related to dry, hacking cough.
• C. Ineffective individual coping with COPD.
• D. Pain related to immobilization of affected leg.

Correct answer: A

Rationale: The patient's symptoms of shortness of breath, orthopnea, thick, tenacious secretions, and a dry hacking cough all point towards a potential airway clearance issue. This makes option A, 'Ineffective airway clearance related to thick, tenacious secretions,' the most appropriate nursing diagnosis. It directly addresses the thick secretions and suggests a potential cause of the breathing difficulty the patient is experiencing.

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