Nursing Elites

1. The nurse is planning care for a client with pneumococcal pneumonia. Which of the following would be most effective in removing respiratory secretions?

• A. Administration of cough suppressants
• B. Increasing oral fluid intake to 3000 cc per day
• C. Maintaining bed rest with bathroom privileges
• D. Performing chest physiotherapy twice a day

Correct answer: B

Rationale: Increasing oral fluid intake to 3000 cc per day is the most effective in removing respiratory secretions in a client with pneumococcal pneumonia. Adequate hydration helps thin secretions, making them easier to expectorate. Administration of cough suppressants (Choice A) may hinder the removal of secretions by suppressing the cough reflex. Maintaining bed rest with bathroom privileges (Choice C) is important but does not directly address the removal of respiratory secretions. Performing chest physiotherapy (Choice D) is beneficial for mobilizing secretions but may not be as effective as increasing fluid intake in thinning and facilitating the removal of secretions.

2. The nurse is teaching a client with cardiac disease about the anatomy and physiology of the heart. Which is the correct pathway of blood flow through the heart?

• A. Right ventricle, left ventricle, right atrium, left atrium
• B. Left ventricle, right ventricle, left atrium, right atrium
• C. Right atrium, right ventricle, left atrium, left ventricle
• D. Right atrium, left atrium, right ventricle, left ventricle

Correct answer: C

Rationale: The correct pathway of blood flow through the heart starts with blood entering the right atrium, moving to the right ventricle, then to the lungs for oxygenation, returning to the left atrium, and finally to the left ventricle before being pumped out to the body. Option A is incorrect as it starts with the ventricles instead of the atria. Option B is incorrect as it has the sequence of ventricles before atria reversed. Option D is incorrect as it has the atria and ventricles mixed up.

3. A client presents at a community-based clinic with complaints of shortness of breath, headache, dizziness, and nausea. During the assessment, the nurse learns that the client is a migrant worker who often uses a gasoline-powered pressure washer to clean equipment and farm buildings. Which type of poisoning is the most likely etiology of this client's symptoms?

• A. asbestos
• B. silica dust
• C. histoplasmosis
• D. carbon monoxide

Correct answer: D

Rationale: The client's symptoms of shortness of breath, headache, dizziness, and nausea are indicative of carbon monoxide poisoning, which can result from exposure to gasoline-powered equipment like pressure washers. Asbestos (Choice A) exposure would typically present with respiratory issues and cancer but not the rapid onset of symptoms described. Silica dust (Choice B) exposure is associated with respiratory conditions like silicosis, not the multisystem symptoms in the scenario. Histoplasmosis (Choice C) is a fungal infection that primarily affects the lungs and is not related to the client's exposure to a gasoline-powered pressure washer.

4. Community health nurses help influence the health of communities through which of the following actions?

• A. legislating health behavior
• B. recording health status of individuals in a similar geographic region
• C. influencing health status and behavior, and engaging in health promotion
• D. none of the above

Correct answer: C

Rationale: Community health nurses play a crucial role in influencing the health of communities by engaging in health promotion activities and influencing health behaviors. Choice A is incorrect as community health nurses do not legislate health behavior but rather educate and promote healthy behaviors. Choice B is incorrect as while community health nurses may record health data, their main focus is on proactive health promotion and intervention, not just documenting health status. Choice D is incorrect because community health nurses actively work to influence health status and behaviors.

5. A nurse is preparing to administer a tuberculosis (TB) test to a client. Which of the following is the correct method for administering this test?

• A. Intradermal injection on the forearm
• B. Subcutaneous injection on the upper arm
• C. Intramuscular injection on the deltoid
• D. Oral administration

Correct answer: A

Rationale: The correct method for administering a tuberculosis (TB) test is through an intradermal injection on the forearm. This technique allows for the proper administration of the test under the skin to assess the body's response to the TB antigen. Choices B, C, and D are incorrect because the TB test specifically requires an intradermal injection, not subcutaneous, intramuscular, or oral administration.

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