Nursing Elites

1. The client is prescribed a long-acting beta2 agonist and expresses concerns about the cost, stating they only use the inhaler during asthma attacks. How should the nurse respond?

• A. Explain the importance of using the inhaler daily to prevent asthma attacks.
• B. Suggest identifying community services to help with the cost and encourage daily use of the inhaler.
• C. Explore the client's fears regarding breathlessness.
• D. Emphasize the necessity of using this inhaler daily and discuss potential community services for financial assistance.

Correct answer: B

Rationale: The correct response should address the client's concern about the cost of using the inhaler daily. While emphasizing the importance of daily use is crucial, it is also essential to acknowledge and offer support for the financial burden. Identifying community resources can help the client access affordable medications. Exploring fears related to breathlessness does not directly address the client's financial concerns.

2. During an acute asthma attack in a client with asthma, what medication should the nurse administer first?

• A. Oral corticosteroids
• B. Short-acting beta agonist
• C. Leukotriene receptor antagonist
• D. Long-acting beta agonist

Correct answer: B

Rationale: During an acute asthma attack, the priority is to quickly relieve bronchospasm and improve breathing. Short-acting beta agonists, like albuterol, are the first-line medications as they rapidly relax bronchial muscles, providing immediate relief. Oral corticosteroids are used as adjunct therapy to reduce airway inflammation over time, while leukotriene receptor antagonists and long-acting beta agonists are not appropriate for immediate relief during an acute attack.

3. A client has a pulmonary embolism & is started on oxygen. The student nurse asks why the client's oxygen saturation has not significantly improved. What response by the nurse is best?

• A. Breathing so rapidly interferes with oxygenation.
• B. Maybe the client has respiratory distress syndrome.
• C. The blood clot interferes with perfusion in the lungs.
• D. The client needs immediate intubation & mechanical ventilation.

Correct answer: C

Rationale: A large blood clot in the lungs will significantly impair gas exchange & oxygenation. Unless the clot is dissolved, this process will continue unabated.

4. A post-anesthesia care unit nurse is caring for a client who is postoperative following a thoracotomy and lobectomy. Which of the following postoperative assessments should the nurse give the highest priority to?

• A. Arterial blood gases
• B. Urinary output
• C. Chest tube drainage
• D. Pain level

Correct answer: A

Rationale: Arterial blood gases are crucial to assess postoperatively in a client who has undergone thoracotomy and lobectomy to monitor oxygenation and ventilation status. Changes in arterial blood gases can indicate respiratory complications or inadequate gas exchange, which are critical issues that need prompt intervention to prevent further complications. While urinary output, chest tube drainage, and pain level are important assessments, monitoring arterial blood gases takes precedence in this specific postoperative scenario to ensure optimal respiratory function and overall patient well-being.

5. A patient is assessing a client who has just been admitted to the emergency department. The client is having difficulty breathing and is using accessory muscles. What action by the nurse is best?

• A. Administer oxygen at 2 liters per minute via nasal cannula.
• B. Assess the client's vital signs including oxygen saturation.
• C. Notify the Rapid Response Team immediately.
• D. Place the client in a high Fowler's position.

Correct answer: D

Rationale: Placing the client in a high Fowler's position is the best action in this situation as it helps to maximize lung expansion, improve breathing, and decrease the work of breathing. This position allows for better chest expansion, improving oxygenation and ventilation for the client in respiratory distress.

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