Nursing Elites

1. How should a healthcare provider respond to a patient experiencing acute chest pain?

• A. Administer prescribed nitroglycerin
• B. Provide oxygen
• C. Call for emergency assistance
• D. Reassure the patient

Correct answer: A

Rationale: In the case of a patient experiencing acute chest pain, the initial response should include administering prescribed nitroglycerin. Nitroglycerin helps dilate blood vessels and improve blood flow to the heart, which can be beneficial in managing chest pain related to cardiac issues. Providing oxygen can also be helpful to support oxygenation. However, the priority in this scenario is to address the potential cardiac cause by administering nitroglycerin. Calling for emergency assistance is crucial if the patient's condition does not improve or deteriorates. Reassuring the patient is essential for emotional support but should not be the primary intervention in the case of acute chest pain.

2. A client with diabetes is experiencing hyperglycemia. What is the nurse's priority?

• A. Administer insulin
• B. Encourage the client to exercise to lower blood glucose
• C. Encourage the client to drink water
• D. Administer glucagon

Correct answer: A

Rationale: The correct answer is to administer insulin. In hyperglycemia, there is an excess of glucose in the blood, which needs to be lowered. Insulin is the primary medication used to lower blood glucose levels by facilitating the uptake of glucose into cells. Encouraging the client to exercise may further increase blood glucose levels due to the release of stress hormones, so it is not the priority. While staying hydrated is important, it will not directly address the high blood glucose levels seen in hyperglycemia. Glucagon is used to treat severe hypoglycemia, not hyperglycemia, so it is not the priority in this situation.

3. What is an appropriate teaching point for a client with left-leg weakness learning to use a cane?

• A. Maintain two points of support on the ground at all times
• B. Use the cane on the weak side of the body
• C. Advance the cane 30 to 45 cm with each step
• D. Advance the cane and the strong leg simultaneously

Correct answer: A

Rationale: The correct teaching point for a client with left-leg weakness learning to use a cane is to maintain two points of support on the ground at all times. This ensures stability and helps prevent falls. Choice B, using the cane on the weak side of the body, may lead to imbalance and decreased support. Choice C, advancing the cane a specific distance with each step, is not as crucial as maintaining two points of support. Choice D, advancing the cane and the strong leg simultaneously, may also compromise stability and support for the weak leg.

4. What are the key signs of respiratory distress?

• A. Increased respiratory rate and use of accessory muscles
• B. Decreased respiratory rate and cyanosis
• C. Cyanosis and use of accessory muscles
• D. Altered mental status and bradycardia

Correct answer: A

Rationale: The correct answer is A: Increased respiratory rate and use of accessory muscles are key signs of respiratory distress. When a person is experiencing respiratory distress, their respiratory rate typically increases as the body tries to compensate for the inadequate oxygenation. Additionally, the use of accessory muscles indicates that the person is working harder to breathe. Choices B, C, and D are incorrect because they do not accurately represent the key signs of respiratory distress. A decreased respiratory rate, cyanosis, altered mental status, and bradycardia are not typical signs of respiratory distress.

5. What is the first step in assessing a patient with suspected stroke?

• A. Check for facial droop
• B. Assess speech clarity
• C. Perform a neurological assessment
• D. Call for emergency assistance

Correct answer: D

Rationale: The correct answer is to call for emergency assistance (Option D) when assessing a patient with suspected stroke. Time is crucial in stroke management, and activating emergency services promptly can ensure timely access to specialized care such as stroke units and treatments like thrombolytic therapy. Checking for facial droop (Option A), assessing speech clarity (Option B), and performing a neurological assessment (Option C) are important steps in evaluating a stroke but should follow the immediate action of calling for emergency assistance. These initial assessments can help confirm the suspicion of a stroke and provide valuable information to healthcare providers when they arrive. However, the priority is to ensure the patient receives appropriate care without delay by activating emergency services.

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