Nursing Elites

1. The nurse completes discharge teaching for a patient who has had a lung transplant. The nurse evaluates that the teaching has been effective if the patient makes which statement?

• A. I will make an appointment to see the doctor every year.
• B. I will stop taking the prednisone if I experience a dry cough.
• C. I will not worry if I feel a little short of breath with exercise.
• D. I will call the health care provider right away if I develop a fever.

Correct answer: D

Rationale: The correct answer is, 'I will call the health care provider right away if I develop a fever.' It is crucial for patients who have undergone a lung transplant to be vigilant about any signs of infection or rejection. A low-grade fever can be an early indicator of such complications, requiring immediate medical attention. While annual follow-up visits are necessary, they are not sufficient for monitoring acute changes in health post-transplant. Stopping prednisone abruptly can lead to rejection and should only be done under healthcare provider guidance. Feeling short of breath with exercise should be reported as it can indicate potential issues. Recognizing and addressing symptoms promptly is key to successful post-transplant care, and in this case, calling the healthcare provider immediately for a fever is the most appropriate action.

2. Which of the following statements best describes postural drainage as part of chest physiotherapy?

• A. Tapping on the chest wall to loosen secretions
• B. Squeezing the abdomen to increase expansion of the upper chest
• C. Using gravity to move secretions in the lung tissue
• D. Dilating the trachea to facilitate better release of secretions

Correct answer: C

Rationale: Postural drainage is a technique used in chest physiotherapy for clients with accumulated lung secretions. It involves positioning the client to utilize gravity in moving secretions from the lungs. Choice A, tapping on the chest wall, describes percussion, not postural drainage. Choice B, squeezing the abdomen, is not a correct description of postural drainage. Choice D, dilating the trachea, is not related to postural drainage but may be associated with airway clearance techniques.

3. Which of the following medications taken by the patient is least likely to cause urine discoloration?

• A. Sulfasalazine
• B. Levodopa
• C. Phenolphthalein
• D. Aspirin

Correct answer: D

Rationale: The correct answer is Aspirin. Aspirin is not known to cause urine discoloration. Sulfasalazine is associated with causing orange-yellow discoloration of urine. Levodopa can cause darkening of urine to a brown or black color. Phenolphthalein has been linked to pink or red discoloration of urine. Therefore, among the options provided, Aspirin is the medication least likely to cause urine discoloration.

4. A patient has been diagnosed with acute gastritis in a clinic. Which of the following medications would be contraindicated for this patient?

• A. Naproxen sodium (Naprosyn)
• B. Calcium carbonate
• C. Clarithromycin (Biaxin)
• D. Furosemide (Lasix)

Correct answer: A

Rationale: Naproxen sodium is a nonsteroidal anti-inflammatory drug that can cause inflammation of the upper GI tract. For this reason, it is contraindicated in a patient with gastritis. Gastritis involves inflammation of the stomach lining, and medications like Naproxen can exacerbate this condition. Calcium carbonate is an antacid that can help neutralize stomach acid and may actually provide relief for gastritis symptoms. Clarithromycin is an antibiotic used to treat H. pylori infection, a common cause of gastritis. Furosemide is a loop diuretic used to treat conditions like edema and hypertension, not directly contraindicated in gastritis.

5. The patient is being taught about pulmonary function testing (PFT). Which statement made by the patient indicates effective teaching?

• A. I will use my inhaler right before the test.
• B. I won't eat or drink anything 8 hours before the test.
• C. I should inhale deeply and blow out as hard as I can during the test.
• D. My blood pressure and pulse will be checked every 15 minutes after the test.

Correct answer: C

Rationale: The correct answer is 'I should inhale deeply and blow out as hard as I can during the test.' This statement indicates effective teaching because for PFT, the patient needs to inhale deeply and exhale forcefully. This maneuver helps in assessing lung function accurately. Choices A, B, and D are incorrect. Using an inhaler right before the test may alter the test results, which is not recommended. Fasting for 8 hours is not necessary for a PFT, and checking blood pressure and pulse every 15 minutes after the test is not part of the PFT procedure.

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