Nursing Elites

1. A healthcare professional wishes to provide client-centered care in all interactions. Which action by the healthcare professional best demonstrates this concept?

• A. Assesses for cultural influences affecting healthcare
• B. Ensures that all the client's basic needs are met
• C. Informs the client and family about all upcoming tests
• D. Thoroughly orients the client and family to the room

Correct answer: A

Rationale: Client-centered care focuses on individualizing care to meet the client's unique needs, preferences, and values. Assessing for cultural influences affecting healthcare allows the healthcare professional to provide culturally sensitive and competent care, respecting the client's beliefs and practices. It promotes effective communication, understanding, and collaboration, essential components of client-centered care.

2. A healthcare professional assesses a client who is experiencing an acute asthma attack. Which assessment finding requires immediate intervention?

• A. Loud wheezing
• B. Increased respiratory rate
• C. Use of accessory muscles
• D. Silent chest

Correct answer: D

Rationale: A silent chest in a client experiencing an acute asthma attack indicates severe airway obstruction and impending respiratory failure. It is a critical finding that requires immediate intervention as it signifies a lack of airflow and ventilation. Loud wheezing, increased respiratory rate, and use of accessory muscles are common signs of an asthma attack and indicate the body's attempt to compensate. However, a silent chest suggests a dangerous lack of airflow that necessitates urgent medical attention to prevent respiratory arrest.

3. A client with Parkinson's disease is prescribed carbidopa-levodopa (Sinemet). What should the nurse include in the teaching about this medication?

• A. Take the medication without a high-protein meal.
• B. Expect the medication to take several weeks to reach full effectiveness.
• C. The medication may cause urine to turn light.
• D. You may experience a rapid heartbeat as a common side effect.

Correct answer: B

Rationale: Patients prescribed carbidopa-levodopa should be informed that it may take several weeks for the medication to reach its full therapeutic effectiveness in managing Parkinson's disease symptoms. This delayed onset of action is important for patients to be aware of to prevent premature discontinuation of the medication due to perceived lack of efficacy.

4. A client is 1 day postoperative following a lobectomy with a chest tube drainage system in place. Which finding by the nurse indicates a need for intervention?

• A. Chest tube eyelets not visible
• B. Continuous bubbling in the suction control chamber
• C. Presence of tidal fluctuation in the water seal chamber
• D. Development of subcutaneous emphysema

Correct answer: D

Rationale: The development of subcutaneous emphysema is a concerning finding that requires immediate intervention. Subcutaneous emphysema results from air leaking into the tissues, which can lead to respiratory compromise. It is important to address this issue promptly to prevent further complications. The other options are normal or expected findings in a chest tube drainage system. Chest tube eyelets not being visible may indicate dislodgement, continuous bubbling in the suction control chamber indicates proper functioning, and the presence of tidal fluctuation in the water seal chamber demonstrates appropriate drainage and lung re-expansion.

5. 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.

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