Nursing Elites

1. The client is being prepared for insertion of a pulmonary artery catheter (Swan-Ganz catheter). What information does the client need to know about the purpose of this catheter insertion?

• A. Stroke volume
• B. Cardiac output
• C. Venous pressure
• D. Left ventricular functioning

Correct answer: D

Rationale: The correct answer is D: Left ventricular functioning. The purpose of inserting a pulmonary artery catheter is to obtain information about left ventricular functioning when the catheter balloon is inflated. Choices A, B, and C are incorrect because while a pulmonary artery catheter can provide information on stroke volume, cardiac output, and venous pressure, its primary purpose is to assess left ventricular function.

2. Why are subdural hemorrhages more common in the elderly?

• A. Increased anticoagulant use
• B. Increased risk of falls
• C. Brain atrophy
• D. Inconsistent care giving

Correct answer: C

Rationale: Subdural hemorrhages are more common in the elderly due to cerebral atrophy resulting from the natural aging process. This atrophy can lead to the stretching of bridging veins, making them more fragile and prone to tearing even with minor trauma. While increased anticoagulant use and a higher risk of falls are common in the elderly, brain atrophy plays a more direct role in the increased incidence of subdural hemorrhages. Inconsistent caregiving, on the other hand, is not a direct cause of subdural hemorrhages but may impact the overall management and outcome of such cases.

3. An infant weighed 7 pounds 8 ounces at birth. If growth occurs at a normal rate, what would be the expected weight at 6 months of age?

• A. Double the birth weight
• B. Triple the birth weight
• C. Gain 6 ounces each week
• D. Add 2 pounds each month

Correct answer: A

Rationale: Infants typically double their birth weight by 6 months of age as part of normal growth and development. This doubling of weight is a common milestone used by healthcare providers to assess a baby's growth progress. Tripling the birth weight or adding 2 pounds each month would result in excessive weight gain, which is not typical or healthy for an infant. Similarly, gaining 6 ounces each week would also lead to rapid and abnormal weight gain, making it an incorrect choice.

4. Which patient is at risk for developing oral candidiasis, a type of stomatitis?

• A. A 77-year-old woman in a long-term care facility taking an antibiotic
• B. A 35-year-old man who has had HIV for 6 years
• C. A 40-year-old man who is undergoing chemotherapy
• D. An 80-year-old woman with dentures

Correct answer: A

Rationale: The correct answer is a 77-year-old woman in a long-term care facility taking an antibiotic. This patient has multiple risk factors for developing oral candidiasis, including older age, being in a long-term care facility, and taking antibiotics. Candidiasis can be caused by long-term antibiotic therapy, immunosuppressive therapy (such as chemotherapy), older age, living in a long-term care facility, diabetes, having dentures, and poor oral hygiene. Choices B, C, and D are less likely to be at high risk for oral candidiasis compared to the correct answer.

5. A patient admitted to the hospital with myocardial infarction develops severe pulmonary edema. Which of the following symptoms should the nurse expect the patient to exhibit?

• A. Slow, deep respirations
• B. Stridor
• C. Bradycardia
• D. Air hunger

Correct answer: D

Rationale: In a patient with pulmonary edema following a myocardial infarction, the nurse should expect symptoms such as air hunger, anxiety, and agitation. Air hunger refers to the feeling of needing to breathe more deeply or more often. Other symptoms of pulmonary edema can include coughing up blood or bloody froth, orthopnea (difficulty breathing when lying down), and paroxysmal nocturnal dyspnea (sudden awakening with shortness of breath). Slow, deep respirations (Choice A) are not typical in pulmonary edema; these patients often exhibit rapid, shallow breathing due to the difficulty in oxygen exchange. Stridor (Choice B) is a high-pitched breathing sound often associated with upper airway obstruction, not typically seen in pulmonary edema. Bradycardia (Choice C), a slow heart rate, is not a characteristic symptom of pulmonary edema, which is more likely to be associated with tachycardia due to the body's compensatory response to hypoxia and increased workload on the heart.

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