Nursing Elites

1. A patient with a history of asthma is admitted with shortness of breath. What is the nurse's priority intervention?

• A. Administer a bronchodilator as prescribed.
• B. Encourage the patient to use an incentive spirometer.
• C. Place the patient in a high Fowler's position.
• D. Monitor the patient's oxygen saturation closely.

Correct answer: A

Rationale: The correct answer is to administer a bronchodilator as prescribed. This intervention is the priority for a patient with asthma experiencing shortness of breath as it helps relax the airways, making breathing easier. Encouraging the use of an incentive spirometer (Choice B) is beneficial for lung expansion but not the priority in this acute situation. Placing the patient in a high Fowler's position (Choice C) can also help with breathing but is not as immediate as administering a bronchodilator. While monitoring the patient's oxygen saturation closely (Choice D) is important, the immediate action to address the breathing difficulty is administering a bronchodilator.

2. What is the primary purpose of turning and repositioning an immobile patient every 2 hours?

• A. To improve circulation and relieve pressure.
• B. To prevent contractures and muscle atrophy.
• C. To prevent skin breakdown and pressure ulcers.
• D. To improve respiratory function and prevent pneumonia.

Correct answer: C

Rationale: The primary purpose of turning and repositioning an immobile patient every 2 hours is to prevent skin breakdown and pressure ulcers. Prolonged immobility can lead to pressure ulcers, making this a crucial nursing intervention. Choice A is incorrect because while turning can help improve circulation and relieve pressure, the primary purpose is to prevent skin breakdown. Choice B is incorrect as preventing contractures and muscle atrophy is important but not the primary purpose of turning. Choice D is incorrect as improving respiratory function and preventing pneumonia are not directly related to turning and repositioning for skin integrity.

3. How should a healthcare provider manage a patient with deep vein thrombosis (DVT)?

• A. Monitoring for signs of pulmonary embolism
• B. Applying compression stockings
• C. Administering anticoagulants as prescribed
• D. Encouraging leg elevation to reduce swelling

Correct answer: A

Rationale: Corrected Rationale: Monitoring for signs of pulmonary embolism is crucial in patients with deep vein thrombosis (DVT) as it can be a life-threatening complication. While administering anticoagulants as prescribed is important for preventing clot progression, the immediate concern is detecting potential pulmonary embolism. Applying compression stockings and encouraging leg elevation are beneficial measures for managing DVT symptoms but are not as critical as monitoring for pulmonary embolism.

4. A patient is receiving an opioid analgesic for pain management. What is the most important assessment for the nurse to perform?

• A. Monitor the patient's blood pressure.
• B. Assess the patient's respiratory rate.
• C. Monitor the patient's oxygen saturation.
• D. Assess the patient's heart rate.

Correct answer: B

Rationale: The correct answer is to assess the patient's respiratory rate. When a patient is receiving opioids, it is crucial to monitor their respiratory rate as opioids can depress the respiratory system, leading to respiratory depression and potential respiratory failure. Monitoring blood pressure, oxygen saturation, and heart rate are important assessments as well, but the priority lies in assessing respiratory rate due to the risk of respiratory depression associated with opioid use.

5. A nurse discovers a discrepancy in the narcotics log. What is the appropriate next step?

• A. Correct the log and notify the pharmacy.
• B. Report the discrepancy to the nurse manager.
• C. Re-administer the narcotic.
• D. Dispose of the narcotic and note the discrepancy.

Correct answer: B

Rationale: When a nurse discovers a discrepancy in the narcotics log, the appropriate next step is to report the discrepancy to the nurse manager. This is important to ensure that the issue is properly investigated and addressed. Choice A is incorrect because simply correcting the log and notifying the pharmacy may not address the root cause of the discrepancy. Choice C is incorrect as re-administering the narcotic without clarification could lead to potential harm or legal issues. Choice D is incorrect as disposing of the narcotic without following proper protocols and documentation could result in further complications.

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