Nursing Elites

1. The client has a long leg cast. During discharge teaching about appropriate exercises for the affected extremity, the nurse should recommend:

• A. Isometric
• B. Range of motion
• C. Aerobic
• D. Isotonic

Correct answer: D

Rationale: The nurse should recommend isometric exercises for the muscles of the casted extremity. Isometric exercises involve contracting and relaxing muscles without moving the affected part. This type of exercise helps maintain muscle strength without moving the joint, which is important for clients with immobilized extremities. Range of motion exercises involve moving the joint through its full range of motion, which may not be suitable for a client with a long leg cast. Aerobic exercises focus on increasing cardiovascular endurance and may not be appropriate for a client with a casted extremity. Isotonic exercises involve muscle contractions with movement, which may not be safe for the affected extremity in a cast.

2. A client with a broken femur is in a traction splint in bed. Which of the following interventions is NOT part of caring for this client?

• A. Palpating the temperature of both feet
• B. Evaluating pulses bilaterally
• C. Turning the client to a side-lying position
• D. Relieving heel pressure by placing a pillow under the foot

Correct answer: C

Rationale: When caring for a client with a broken femur in a traction splint, turning the client to a side-lying position is not recommended. This client is at risk of skin breakdown and complications due to the injury, making it important to prevent unnecessary movement that may increase the risk of injury or discomfort. Palpating the temperature of both feet helps in assessing circulation, evaluating pulses bilaterally ensures perfusion to the extremities, and relieving heel pressure by placing a pillow under the foot helps in reducing pressure points and preventing complications like pressure ulcers. Therefore, the correct answer is turning the client to a side-lying position as it is not a recommended intervention in this scenario.

3. A nurse is assisting a pregnant client who is having an amniocentesis. Which of the following statements by the nurse indicates the correct teaching for this procedure?

• A. I'm going to help you lie lat on your back for this."
• B. Don't worry, I'm sure everything will be all right."
• C. I will need to help you remove your shirt for this procedure."
• D. Now that the procedure is inished, I will put a small bandage over the puncture site."

Correct answer: D

Rationale: An amniocentesis is performed to draw amniotic luid from the sac around the fetus during pregnancy. It may be analyzed for certain disorders or complications associated with pregnancy. Following the procedure, the nurse should wash the client's abdomen and place a small bandage over the puncture site

4. Which of the following types of antipsychotic medications is most likely to produce extrapyramidal effects?

• A. Atypical antipsychotic drugs
• B. First-generation antipsychotic drugs
• C. Third-generation antipsychotic drugs
• D. Dopamine system stabilizers

Correct answer: B

Rationale: The correct answer is first-generation antipsychotic drugs. These drugs are potent antagonists of D2, D3, and D4 receptors, making them effective in treating target symptoms but also leading to numerous extrapyramidal side effects due to the blockade of D2 receptors. Atypical or second-generation antipsychotic drugs, as mentioned in choice A, are relatively weak D2 blockers, which results in a lower incidence of extrapyramidal side effects. Third-generation antipsychotic drugs, as in choice C, and dopamine system stabilizers, as in choice D, are not typically associated with significant extrapyramidal effects compared to first-generation antipsychotics.

5. A client with asthma is being admitted for breathing difficulties. His arterial blood gas results are pH 7.26, PCO2 49, PaO2 90, and HCO3- 21. Which of the following best describes this condition?

• A. Uncompensated respiratory acidosis
• B. Compensated respiratory alkalosis
• C. Uncompensated metabolic acidosis
• D. Compensated metabolic alkalosis

Correct answer: A

Rationale: In this case, the client's arterial blood gas results show a pH of 7.26 and a PCO2 of 49, both of which are abnormal. A pH below the normal range of 7.35-7.45 indicates acidosis. The elevated PCO2 of 49 mmHg suggests respiratory acidosis as the primary issue. The normal range for PCO2 is 35-45 mmHg, so a value of 49 indicates the retention of excess CO2, leading to acidosis. The low HCO3- level of 21 also supports the presence of metabolic acidosis; however, the primary abnormality is respiratory, making this an uncompensated respiratory acidosis. Therefore, the correct answer is 'Uncompensated respiratory acidosis.' Choice B, 'Compensated respiratory alkalosis,' is incorrect because the client's pH is acidic, not alkalotic. Additionally, there is no compensation occurring for the primary respiratory acidosis indicated by the elevated PCO2. Choice C, 'Uncompensated metabolic acidosis,' is incorrect because while the HCO3- level is low, the primary issue indicated by the elevated PCO2 is respiratory acidosis. Choice D, 'Compensated metabolic alkalosis,' is incorrect since the arterial blood gas results do not support a metabolic alkalosis. The low HCO3- level would typically be seen in metabolic acidosis, but in this case, the primary issue is respiratory acidosis.

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