Nursing Elites

1. Why is a precise amount of oxygen necessary for a patient with COPD to prevent which complication?

• A. Cardiac arrest related to increased partial pressure of carbon dioxide in arterial blood (PaCO2)
• B. Circulatory overload due to hypervolemia
• C. Respiratory excitement
• D. Inhibition of the respiratory hypoxic stimulus

Correct answer: D

Rationale: In patients with COPD, the respiratory drive is often stimulated by low oxygen levels. Administering too much oxygen can inhibit this hypoxic drive, leading to respiratory depression and potential respiratory failure. Therefore, it is crucial to carefully regulate the oxygen therapy to prevent the inhibition of the respiratory hypoxic stimulus in COPD patients.

2. Which of the following substances increase the amount of urine produced?

• A. Caffeine-containing drinks, such as coffee and cola
• B. Beets
• C. Urinary analgesics
• D. Kaolin with pectin (Kaopectate)

Correct answer: A

Rationale: Caffeine is a diuretic, which means it increases urine production by promoting the excretion of water from the body through the kidneys. Therefore, substances like caffeine-containing drinks, such as coffee and cola, can lead to an increase in the amount of urine produced.

3. When creating a plan of care for a newly admitted client with obsessive-compulsive disorder, which of the following interventions should the nurse take?

• A. Allow the client enough time to perform rituals
• B. Give the client autonomy in scheduling activities
• C. Discourage the client from exploring irrational fears
• D. Provide negative reinforcement for ritualistic behaviors

Correct answer: A

Rationale: Individuals with obsessive-compulsive disorder often feel compelled to perform rituals to alleviate anxiety. Allowing the client enough time to perform these rituals can help reduce their anxiety levels and promote a sense of control. Providing autonomy in scheduling activities can also empower the client and enhance their sense of independence. Discouraging exploration of irrational fears may increase anxiety and worsen symptoms. Negative reinforcement for ritualistic behaviors is not recommended as it can be counterproductive and reinforce the behavior.

4. Which of the following actions should be taken to use a wide base support when assisting a client to get up in a chair?

• A. Bend at the waist and place arms under the client’s arms and lift
• B. Face the client, bend knees, and place hands on the client’s forearm and lift
• C. Spread the feet apart
• D. Tighten the pelvic muscles

Correct answer: C

Rationale: The correct answer is C: Spread the feet apart. When assisting a client to get up in a chair, it is crucial to use a wide base of support to maintain stability and prevent injuries. Spreading the feet apart provides a broader base, increasing balance and support for both the client and the caregiver. This position helps distribute the weight evenly and allows for better control when assisting the client in moving. Choices A, B, and D are incorrect because bending at the waist, placing arms under the client's arms, tightening pelvic muscles, or placing hands on the client's forearm do not provide the necessary wide base support needed for stability and safety during the transfer process.

5. A healthcare professional is preparing to administer a dose of a new prescription of prednisone to a client who has COPD. The healthcare professional should not concentrate on which of the following adverse effects of this medication?

• A. Hypokalemia
• B. Tachycardia
• C. Fluid retention
• D. Black, tarry stools

Correct answer: B

Rationale: When administering prednisone, a corticosteroid medication, to a client with COPD, the healthcare professional should be aware of potential adverse effects. Tachycardia is not a common adverse effect of prednisone use. The correct adverse effects to monitor for include hypokalemia, fluid retention, and gastrointestinal issues like black, tarry stools due to potential gastrointestinal bleeding. Therefore, the healthcare professional should not concentrate on tachycardia but should focus on the other listed adverse effects when administering prednisone to a client with COPD.

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