Nursing Elites

1. A client is interested in smoking cessation. Which statements should the nurse include in this client's teaching? (Select ONE that does not apply)

• A. Find an activity that you enjoy and will keep your hands busy.
• B. Make a list of reasons you want to stop smoking.
• C. Identify a punishment for yourself in case you backslide.
• D. Drink at least eight glasses of water each day.

Correct answer: D

Rationale: When educating a client on smoking cessation, the nurse should include several strategies. Finding an activity to keep hands busy helps distract from smoking urges. Making a list of reasons to quit smoking reinforces motivation. Identifying a consequence for backsliding can serve as a deterrent. Drinking water is beneficial for overall health but is not directly related to smoking cessation. It's crucial to support the client, encourage healthy habits, and address challenges without punitive measures.

2. A client with chronic obstructive pulmonary disease is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Eat 3 balanced meals each day.
• B. Limit fluid intake with meals.
• C. Reduce sodium intake.
• D. Take a bronchodilator 1 hour before eating.

Correct answer: B

Rationale: In clients with chronic obstructive pulmonary disease, limiting fluid intake with meals can help reduce the risk of bloating and feeling too full, which can make breathing more difficult due to increased pressure on the diaphragm. It is important to encourage a balanced diet with appropriate fluid intake between meals to maintain hydration and proper nutrition. Options A, C, and D are not specifically related to dietary recommendations for clients with chronic obstructive pulmonary disease.

3. A client in a clinic presents with an acute asthma exacerbation. Which of the following medications should reduce the symptoms?

• A. Cromolyn via a metered-dose inhaler
• B. Montelukast orally
• C. Budesonide via a dry-powder inhaler
• D. Albuterol via a jet nebulizer

Correct answer: D

Rationale: During an acute asthma exacerbation, the preferred medication for symptom relief is a short-acting beta-agonist like albuterol, typically delivered via a jet nebulizer for quick onset and efficacy. Cromolyn, montelukast, and budesonide are not as effective for immediate symptom relief in acute exacerbations and are more commonly used for prevention or long-term management of asthma symptoms.

4. During an admission assessment of a client with COPD and emphysema complaining of a frequent productive cough and shortness of breath, what assessment finding should the nurse anticipate?

• A. Respiratory alkalosis
• B. Increased anteroposterior diameter of the chest
• C. Oxygen saturation level 96%
• D. Petechiae on chest

Correct answer: B

Rationale: COPD and emphysema are chronic respiratory conditions that can lead to changes in the shape of the chest. In clients with COPD, the anteroposterior diameter of the chest often increases, giving a barrel chest appearance. This change in chest shape is due to hyperinflation of the lungs and is a common physical finding in clients with COPD and emphysema. The other options are not typically associated with COPD and emphysema. Respiratory alkalosis is not a common finding in these clients. An oxygen saturation level of 96% is within the normal range and does not specifically relate to COPD. Petechiae on the chest are not typically associated with COPD or emphysema.

5. A client with chronic obstructive pulmonary disease (COPD) is being taught by a healthcare provider. Which statement by the client indicates a need for further teaching?

• A. I will avoid smoking to prevent further damage to my lungs.
• B. I will eat smaller, more frequent meals to avoid feeling bloated.
• C. I will exercise every day to improve my strength and endurance.
• D. I will drink plenty of fluids to help thin my mucus.

Correct answer: C

Rationale: The correct answer is C. While exercise is important for clients with COPD, daily exercise may be too strenuous. Clients should be encouraged to exercise regularly but should be advised to avoid overexertion. Statements A, B, and D demonstrate appropriate understanding and management of COPD symptoms.

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