Nursing Elites

1. A nurse is reviewing information about advance directives with a newly admitted client. Which statement by the client indicates an understanding of the teaching?

• A. My family can make decisions if I am unable to.
• B. I have a living will that outlines my wishes when I am unable to make a decision.
• C. I can write down my wishes, but they aren't legally binding.
• D. I don't need to worry about this until I’m critically ill.

Correct answer: B

Rationale: Choice B is the correct answer because having a living will is a legal document that outlines a client's wishes when they are unable to make decisions, indicating a good understanding of advance directives. Choice A is incorrect because it doesn't mention a specific document like a living will. Choice C is incorrect because advance directives, like a living will, can be legally binding. Choice D is incorrect because planning for advance directives should ideally be done before a person becomes critically ill.

2. A healthcare provider is assessing a client with chronic obstructive pulmonary disease (COPD). Which of the following findings should the healthcare provider expect?

• A. Decreased respiratory rate
• B. Use of accessory muscles
• C. Improved lung sounds
• D. Increased energy levels

Correct answer: B

Rationale: The correct answer is B: 'Use of accessory muscles.' Clients with COPD often experience airway obstruction, leading to the use of accessory muscles to breathe. This compensatory mechanism helps them overcome the increased work of breathing. Choice A, 'Decreased respiratory rate,' is incorrect because clients with COPD typically have an increased respiratory rate due to the need for more effort to breathe. Choice C, 'Improved lung sounds,' is incorrect because COPD is characterized by wheezes, crackles, and diminished breath sounds. Choice D, 'Increased energy levels,' is incorrect because clients with COPD often experience fatigue due to the increased work of breathing and impaired gas exchange.

3. A nurse is caring for a client who sprained his ankle 12 hours ago. Which of the following provider prescriptions should the nurse question?

• A. Elevate the affected extremity on two pillows
• B. Apply heat to the affected extremity for 45 minutes
• C. Wrap the extremity with a compression dressing
• D. Assess sensation, movement, and pulse every 4 hours

Correct answer: B

Rationale: The nurse should question the prescription to apply heat to the affected extremity for 45 minutes. Heat should not be applied in the first 48 hours after an acute injury, as it can increase swelling. Cold therapy is more appropriate initially. Choices A, C, and D are appropriate actions in the care of a client with a sprained ankle. Elevating the affected extremity helps reduce swelling, wrapping it with a compression dressing provides support, and assessing sensation, movement, and pulse every 4 hours is important to monitor for complications.

4. A nurse is admitted to a psychiatric unit and fails to follow her medication regimen. What does this behavior indicate?

• A. Early cognitive impairment
• B. Lack of motivation
• C. Lack of health literacy
• D. Worsening health state

Correct answer: C

Rationale: The correct answer is C, 'Lack of health literacy.' The nurse's inability to follow the medication regimen suggests she may lack health literacy, meaning she may not fully understand how to manage her own health care. Choice A, 'Early cognitive impairment,' is not supported by the information provided in the question as there is no mention of cognitive decline. Choice B, 'Lack of motivation,' is less likely as the behavior is more indicative of a knowledge deficit rather than a lack of drive. Choice D, 'Worsening health state,' is also less likely as the behavior described does not directly imply a worsening health condition but rather a misunderstanding or lack of knowledge on managing health.

5. A nurse is teaching a client with mild persistent asthma about montelukast. Which statement by the client indicates understanding?

• A. I will use this for asthma attacks.
• B. I should take this before exercise.
• C. This medication will decrease swelling and mucus production.
• D. I can stop this medication after 10 days.

Correct answer: C

Rationale: Montelukast is a leukotriene receptor antagonist that helps reduce swelling and mucus production in the airways, making it useful for long-term asthma management.

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