Nursing Elites

1. When teaching a patient with COPD pulmonary exercises, what should be done?

• A. Teach pursed-lip breathing techniques.
• B. Encourage repetitive heavy lifting exercises to increase strength.
• C. Limit exercises due to respiratory acidosis.
• D. Take breaks every 10-20 minutes during exercises.

Correct answer: A

Rationale: The correct answer is to teach pursed-lip breathing techniques. Pursed-lip breathing helps to decrease the volume of air expelled by keeping the airways open longer, making it easier for patients with COPD to breathe out. Encouraging heavy lifting exercises (Choice B) is not suitable for patients with COPD as it can lead to increased shortness of breath. Limiting exercises due to respiratory acidosis (Choice C) is not correct; instead, exercises should be tailored to the patient's tolerance. Taking breaks every 10-20 minutes (Choice D) is not specific to the management of COPD pulmonary exercises.

2. After experiencing a left frontal lobe CVA, a fifty-five-year-old man is being monitored by a nurse. The patient's family is not present in the room. What should the nurse observe most closely for?

• A. Changes in emotion and behavior
• B. Monitor loss of hearing
• C. Observe appetite and vision deficits
• D. Changes in facial muscle control

Correct answer: A

Rationale: The correct answer is to watch for changes in emotion and behavior. The frontal lobe, particularly the left side, is responsible for regulating behavior and emotions. Therefore, following a left frontal lobe CVA, monitoring for alterations in emotion and behavior is crucial. Choices B, C, and D are incorrect because loss of hearing, appetite and vision deficits, and changes in facial muscle control are not directly associated with a left frontal lobe CVA.

3. Which of the following procedures describes an opening between the colon and abdominal wall?

• A. ileostomy
• B. jejunostomy
• C. colostomy
• D. cecostomy

Correct answer: C

Rationale: A colostomy is an opening between the colon and abdominal wall. An ileostomy is an opening between the ileum and abdominal wall, not the colon. Jejunostomy is an opening between the jejunum and abdominal wall, and cecostomy is an opening into the cecum. The term 'colostomy' specifically refers to the surgical procedure where a part of the colon is brought through the abdominal wall to create a stoma, allowing feces to leave the body. Therefore, the correct answer is colostomy as it accurately describes the opening between the colon and the abdominal wall, distinct from the other options.

4. When teaching about preventable diseases, the importance of getting the following vaccines should be emphasized:

• A. human papillomavirus, genital herpes, measles.
• B. pneumonia, HIV, mumps.
• C. syphilis, gonorrhea, pneumonia.
• D. polio, pertussis, measles

Correct answer: D

Rationale: Vaccines are crucial in preventing communicable diseases. Smallpox has been eradicated globally, so its vaccine is no longer used. Polio, pertussis, and measles are diseases that are controlled by routine childhood immunization. While smallpox has been eradicated, these diseases still exist, making it essential for children to be vaccinated against them. Choices A, B, and C include diseases that are not prevented by vaccination or are not related to routine immunizations, making them incorrect choices.

5. What could be a possible cause for the symptoms experienced by the client in Question 28?

• A. iron deficiency
• B. folate deficiency
• C. peptic ulcer
• D. iron overload

Correct answer: A

Rationale: Given the client's symptoms of fatigue, shortness of breath, and lightheadedness, along with her gender and fad dieting, the most likely cause is iron deficiency. Iron deficiency commonly presents with these symptoms due to decreased oxygen-carrying capacity in the blood. Folate deficiency would typically present with different symptoms such as mouth sores and changes in skin, not fitting the client's presentation. Peptic ulcer would manifest with abdominal pain, not primarily with the symptoms described. Iron overload would present with symptoms such as joint pain and fatigue, which are not consistent with the client's presentation.

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