Nursing Elites

1. The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?

• A. Decreased anteroposterior diameter
• B. Hyperresonance on percussion
• C. Increased breath sounds
• D. Prolonged expiratory phase

Correct answer: D

Rationale: The correct answer is D: Prolonged expiratory phase. In COPD, there is airflow obstruction leading to difficulty in exhaling air. This results in a prolonged expiratory phase. Choices A, B, and C are incorrect. Decreased anteroposterior diameter is associated with conditions like barrel chest in emphysema, not COPD. Hyperresonance on percussion is typical in conditions like emphysema, not necessarily in COPD. Increased breath sounds are not a typical finding in COPD; instead, diminished breath sounds may be present due to air trapping.

2. A client with acute pancreatitis is experiencing severe abdominal pain. The nurse should implement which of the following interventions?

• A. Encourage oral intake
• B. Administer opioid analgesics
• C. Apply a heating pad to the abdomen
• D. Place the client in a supine position

Correct answer: B

Rationale: The correct intervention for a client with acute pancreatitis experiencing severe abdominal pain is to administer opioid analgesics. Opioids are effective in managing the severe pain associated with acute pancreatitis. Encouraging oral intake may exacerbate the symptoms and is contraindicated due to the need for bowel rest. Applying a heating pad to the abdomen can worsen inflammation and should be avoided. Placing the client in a supine position may not provide relief and could potentially lead to increased discomfort.

3. The nurse is teaching a group of older adults about medication safety. Which of the following should be included in the teaching?

• A. keeping a list of all medications and dosages
• B. sharing medications with family members if they have the same prescription
• C. stopping medications when symptoms improve
• D. doubling up on missed doses

Correct answer: A

Rationale: The correct answer is A: keeping a list of all medications and dosages. Maintaining a comprehensive list of medications and their dosages is essential for older adults to prevent medication errors and dangerous interactions. Choice B is incorrect because sharing medications, even if family members have the same prescription, can lead to unintended adverse effects or inappropriate dosages. Choice C is incorrect as stopping medications when symptoms improve can be harmful if the full course of treatment is not completed. Choice D is incorrect as doubling up on missed doses can result in overdosing and adverse reactions.

4. A community hospital is an example of which level of health care?

• A. Secondary level health care
• B. Primary health care
• C. Tertiary level care
• D. Intermediate level care

Correct answer: A

Rationale: A community hospital is categorized under secondary level health care. Secondary level health care facilities, like community hospitals, provide specialized outpatient care, diagnostic services, and treatment that are more complex than what is offered in primary health care settings. Choice B, primary health care, refers to basic and routine health care services typically provided by family doctors or general practitioners, which is not the level of care provided by community hospitals. Tertiary level care (choice C) involves highly specialized and complex medical services such as neurosurgery or organ transplants, which are beyond the scope of services provided by community hospitals. Intermediate level care (choice D) is not a recognized category in the hierarchy of health care levels.

5. A health program that aims to reduce the incidence of chronic diseases through lifestyle modifications is an example of:

• A. Primary prevention
• B. Secondary prevention
• C. Tertiary prevention
• D. Quaternary prevention

Correct answer: A

Rationale: The correct answer is A: Primary prevention. Primary prevention focuses on preventing the development of diseases or injuries before they occur by promoting healthy behaviors and lifestyles. In this scenario, the health program targeting lifestyle modifications to reduce chronic diseases aligns with primary prevention efforts. Choice B, secondary prevention, involves early detection and treatment to prevent the progression of disease. Choice C, tertiary prevention, focuses on managing and treating existing diseases to prevent complications. Choice D, quaternary prevention, relates to actions taken to mitigate or avoid the consequences of unnecessary or excessive interventions in healthcare.

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