Nursing Elites

1. A client who will undergo a bronchoscopy procedure with a rigid scope and general anesthesia will have their neck in which of the following positions?

• A. A flexed position
• B. An extended position
• C. A neutral position
• D. A hyperextended position

Correct answer: D

Rationale: During a bronchoscopy with a rigid scope and general anesthesia, the provider will typically place the client's neck in a hyperextended position to allow better visualization and access to the airways. This position helps to align the trachea for easier insertion of the scope.

2. A client in an emergency department has a sucking chest wound resulting from a gunshot. The client has a blood pressure of 100/60 mm Hg, a weak pulse rate of 118/min, and a respiratory rate of 40/min. Which of the following actions should the nurse take?

• A. Raise the foot of the bed to a 90� angle
• B. Remove the dressing to inspect the wound
• C. Prepare to insert a central line
• D. Administer oxygen via nasal cannula

Correct answer: D

Rationale: In a client with a sucking chest wound, the priority is to administer oxygen via nasal cannula to improve oxygenation. The client's blood pressure, weak pulse rate, and elevated respiratory rate indicate hypovolemic shock, so increasing oxygen supply is crucial. Raising the foot of the bed, removing the dressing, or preparing to insert a central line are not immediate actions needed for a client with a sucking chest wound and signs of shock.

3. A client with heart failure expresses feelings of burden and thoughts of death to a nurse. How should the nurse respond?

• A. Would you like to talk more about this?
• B. You are lucky to have such a devoted daughter.
• C. It is normal to feel as though you are a burden.
• D. Would you like to meet with the chaplain?

Correct answer: A

Rationale: Depression can occur in clients with heart failure, especially in older adults. When a client expresses thoughts of being a burden and death, it is crucial for the nurse to address these concerns. Offering to talk more about the client's feelings provides an opportunity for open communication and a deeper understanding of the client's emotions. Open-ended questions like the one in choice A encourage the client to express themselves freely, leading to better assessment and client-centered care. Choices B and C fail to address the client's emotional distress directly, and choice D diverts the focus without addressing the client's immediate concerns.

4. A client just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?

• A. Withhold food and liquids until the client's gag reflex returns.
• B. Irrigate the client's throat every 4 hours.
• C. Have the client refrain from talking for 24 hours.
• D. Suction the client's oropharynx frequently.

Correct answer: A

Rationale: After a flexible bronchoscopy, it is crucial to withhold food and liquids until the client's gag reflex returns to prevent aspiration. Irrigating the client's throat every 4 hours, having the client refrain from talking for 24 hours, and frequent suctioning of the oropharynx are not indicated post-bronchoscopy and may even pose risks to the client's recovery.

5. A nurse in an emergency room is caring for a client who sustained partial-thickness burns to both lower legs, chest, face, and both forearms. Which of the following is the priority action the nurse should take?

• A. Insert an indwelling urinary catheter.
• B. Inspect the mouth for signs of inhalation injuries.
• C. Administer intravenous pain medication.
• D. Draw blood for a complete blood cell (CBC) count.

Correct answer: B

Rationale: When caring for a client with burns, especially burns to the face and chest, the priority action for the nurse is to inspect the mouth for signs of inhalation injuries. Inhalation injuries can be life-threatening and may not be immediately apparent. Identifying these injuries early allows for prompt intervention and can significantly impact the client's outcomes. While other actions such as pain management and blood tests are important, assessing for inhalation injuries takes precedence due to its critical nature.

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