Nursing Elites

1. A client is prescribed nicotine replacement therapy. Which statement should the nurse include in this client's teaching?

• A. Smoking while taking this medication will increase your risk of a stroke.
• B. Make a list of reasons why smoking is a bad habit.
• C. Stopping this medication suddenly increases your risk for a heart attack.
• D. Rise slowly when getting out of bed in the morning.

Correct answer: A

Rationale: When a client is prescribed nicotine replacement therapy, it is crucial to emphasize that smoking while using this therapy can increase the risk of a stroke. Smoking while on nicotine replacement therapy can lead to excessive nicotine levels in the body, elevating cardiovascular risks. Therefore, the nurse should educate the client on the importance of avoiding smoking while utilizing this medication. Choices B, C, and D are not relevant to the specific teaching required for a client on nicotine replacement therapy.

2. While caring for a client who was injured in a motor-vehicle crash and reports dyspnea and severe pain, a nurse in the emergency department notes that the client's chest moves inward during inspiration and bulges out during expiration. The nurse should identify this finding as which of the following?

• A. Atelectasis
• B. Flail chest
• C. Hemothorax
• D. Pneumothorax

Correct answer: B

Rationale: Flail chest is characterized by paradoxical chest movement, where the chest moves inward during inspiration and bulges out during expiration. This occurs due to multiple rib fractures causing a segment of the chest wall to move independently from the rest of the thorax. Atelectasis refers to collapsed lung tissue, hemothorax is blood in the pleural space, and pneumothorax is air in the pleural space. In this scenario, the client's presentation aligns with the characteristic findings of flail chest.

3. A nursing student learns about modifiable risk factors for coronary artery disease. Which factors does this include? (SATA)

• A. Age
• B. Hypertension
• C. Obesity
• D. Smoking

Correct answer: B

Rationale: Hypertension, obesity, smoking, and excessive stress are all modifiable risk factors for coronary artery disease. Age is a nonmodifiable risk factor as it is a natural process of life.

4. While caring for a client receiving positive-pressure mechanical ventilation, which intervention should the nurse NOT implement to prevent complications?

• A. Elevate the head of the bed to at least 30�.
• B. Verify the prescribed ventilator settings daily.
• C. Administer pantoprazole as prescribed.
• D. Reposition the endotracheal tube to the opposite side of the mouth daily.

Correct answer: D

Rationale: Repositioning the endotracheal tube to the opposite side of the mouth daily is not a standard practice and can increase the risk of complications, such as accidental extubation or damage to the airway. The endotracheal tube should remain in the initial correct position to ensure proper ventilation and prevent harm to the client. Elevating the head of the bed, verifying ventilator settings, and administering pantoprazole as prescribed are all appropriate interventions to prevent complications in a client receiving positive-pressure mechanical ventilation.

5. A healthcare professional is preparing to administer albuterol syrup 1.6 mg PO tid. Available is albuterol 2 mg/5mL. How many mL should the healthcare professional administer per dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• A. 4 mL
• B. 6 mL
• C. 10 mL
• D. 5.5 mL

Correct answer: A

Rationale: To calculate the mL of albuterol syrup needed per dose, first, determine how many milligrams are in the prescribed dose: 1.6 mg. Next, set up a proportion to find the equivalent mL for 1.6 mg using the given concentration of 2 mg/5mL. The calculation is: (1.6 mg x 5 mL) / 2 mg = 4 mL. Therefore, the correct answer is 4 mL to administer per dose.

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