Nursing Elites

1. The nurse assesses the chest of a patient with pneumococcal pneumonia. Which finding would the nurse expect?

• A. Increased tactile fremitus
• B. Dry, nonproductive cough
• C. Hyperresonance to percussion
• D. A grating sound on auscultation

Correct answer: A

Rationale: Increased tactile fremitus over the area of pulmonary consolidation is expected with bacterial pneumonias, such as pneumococcal pneumonia. Dullness to percussion would be expected due to consolidation. Pneumococcal pneumonia typically presents with a loose, productive cough rather than a dry, nonproductive cough. Hyperresonance to percussion is not a typical finding in pneumonia and may suggest conditions like emphysema. Adventitious breath sounds such as crackles and wheezes are typical in pneumonia, but a grating sound on auscultation is more representative of a pleural friction rub rather than pneumonia.

2. The nurse admits a patient who has a diagnosis of an acute asthma attack. Which statement indicates that the patient may need teaching regarding medication use?

• A. I have not had any acute asthma attacks during the last year.
• B. I became short of breath an hour before coming to the hospital.
• C. I've been taking Tylenol 650 mg every 6 hours for chest-wall pain.
• D. I've been using my albuterol inhaler more frequently over the last 4 days.

Correct answer: D

Rationale: The correct answer is 'I've been using my albuterol inhaler more frequently over the last 4 days.' This statement indicates that the patient may need teaching regarding medication use because an increased need for a rapid-acting bronchodilator suggests an exacerbation of asthma. The patient should be educated on recognizing worsening symptoms and the appropriate actions to take. Choices A, B, and C do not directly relate to asthma exacerbation or the need for medication teaching, making them incorrect. Choice A reflects a lack of recent acute asthma attacks, while choice B describes shortness of breath unrelated to medication use. Choice C mentions Tylenol use for chest-wall pain, which is not indicative of asthma exacerbation or medication teaching needs.

3. Which of the following diseases is caused by the Bordetella pertussis bacterium?

• A. German Measles
• B. RSV
• C. Meningitis
• D. Whooping Cough

Correct answer: D

Rationale: Bordetella pertussis is the bacterium responsible for causing Whooping Cough, also known as pertussis. Meningitis can be caused by various bacteria, but not specifically by Bordetella pertussis. German Measles, also known as Rubella, and RSV (Respiratory Syncytial Virus) are viral infections and are not caused by the Bordetella pertussis bacterium. Therefore, the correct answer is Whooping Cough, caused by Bordetella pertussis.

4. A patient in the cardiac care unit is taking bumetanide (Bumex) for heart issues and is also diagnosed with Parkinson's Disease. An unlicensed assistive personnel is assisting with feeding the patient. Which of these foods should the nurse stress for the patient to eat most?

• A. Foods containing the least amount of salt
• B. Foods containing the most amount of potassium
• C. Foods containing the most amount of calories
• D. Foods containing the most amount of fiber

Correct answer: B

Rationale: Bumex is a loop diuretic that can lead to hypokalemia (low potassium levels). Hypokalemia can be dangerous and lead to various complications. To prevent a hypokalemic crisis, it is crucial to ensure an adequate intake of potassium. Therefore, the nurse should stress the patient to eat foods rich in potassium. Choices A, C, and D are not the priority in this situation. While monitoring salt intake is important in cardiac patients, the immediate concern with bumetanide use is the risk of hypokalemia, making choice B the most appropriate option.

5. In a 24-year-old woman, the term used to define uterine bleeding in which there is no menstruation is:

• A. Oligomenorrhea
• B. Amenorrhea
• C. Menorrhagia
• D. Metrorrhagia

Correct answer: B

Rationale: Amenorrhea is the correct term for the absence of menstrual periods in a woman of childbearing age. It is typically defined as no menstruation for at least three consecutive cycles or six months. Oligomenorrhea refers to infrequent or irregular menstrual periods rather than complete absence. Menorrhagia is characterized by excessive menstrual bleeding, not the absence of menstruation. Metrorrhagia involves irregular, acyclic bleeding between menstrual periods, which is different from the absence of menstruation.

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