Nursing Elites

1. What are the key considerations for managing a patient with chronic obstructive pulmonary disease (COPD)?

• A. Airway Management
• B. Oxygen Therapy
• C. Smoking Cessation
• D. Pulmonary Rehabilitation

Correct answer: A

Rationale: The key considerations for managing a patient with COPD include airway management, ensuring adequate oxygenation, promoting smoking cessation, and incorporating pulmonary rehabilitation. While airway management is crucial for maintaining patency and preventing exacerbations, oxygen therapy helps improve oxygen levels in the blood. Smoking cessation is essential to slow down disease progression and reduce exacerbation risk. Pulmonary rehabilitation plays a vital role in enhancing exercise tolerance and overall quality of life for COPD patients. Therefore, while all options are important in managing COPD, airway management is the most critical aspect.

2. A nurse is caring for a client who has an altered mental status and has become aggressive. Which of the following prescriptions should the nurse clarify with the provider prior to administration?

• A. Haloperidol
• B. Zolpidem
• C. Morphine
• D. Lorazepam

Correct answer: B

Rationale: The correct answer is B: Zolpidem. Zolpidem is a sedative-hypnotic medication that can worsen altered mental status, especially in clients who are already aggressive. Therefore, the nurse should clarify this prescription with the provider before administration to ensure it is safe for the client. Choice A, Haloperidol, is an antipsychotic commonly used to manage aggression in clients with altered mental status, making it an appropriate choice in this scenario. Choice C, Morphine, is an opioid analgesic and would not directly impact the client's altered mental status or aggression. Choice D, Lorazepam, is a benzodiazepine used to manage anxiety and agitation, which could be beneficial in this situation but does not have the same potential to exacerbate altered mental status as Zolpidem.

3. A client with coronary artery disease (CAD) is taking a low-dose aspirin daily. The nurse is reinforcing teaching with the client. The nurse should include that this medication has which of the following therapeutic effects?

• A. Analgesic
• B. Antiplatelet
• C. Anticoagulant
• D. Thrombolytic

Correct answer: B

Rationale: The correct answer is B: Antiplatelet. Aspirin works by inhibiting platelet aggregation, making it an antiplatelet agent. This effect helps reduce the risk of blood clot formation in clients with CAD. Choice A, Analgesic, is incorrect because aspirin's primary action in this context is not pain relief. Choice C, Anticoagulant, is incorrect as aspirin does not directly inhibit coagulation factors. Choice D, Thrombolytic, is incorrect as aspirin does not actively break down clots but rather prevents their formation.

4. A nurse is caring for a client who has a prescription for wound irrigation. Which of the following actions should the nurse take?

• A. Wear sterile gloves when removing the old dressing
• B. Warm the irrigation solution to 40.5°C (105°F)
• C. Cleanse the wound from the center outwards
• D. Use a 20 mL syringe to irrigate the wound

Correct answer: C

Rationale: The correct action for the nurse to take when caring for a client with a prescription for wound irrigation is to cleanse the wound from the center outwards. This technique helps prevent contamination by pushing debris away from the wound rather than into it. Choice A is incorrect because wearing sterile gloves is important during wound care but not specifically mentioned for wound irrigation. Choice B is incorrect because warming the irrigation solution to a specific temperature is not a standard recommendation and can potentially harm the client. Choice D is incorrect because the size of the syringe may vary based on the wound size and depth, so using a 20 mL syringe is not a universal guideline.

5. Which of the following is a key consideration when caring for a client with heart failure on fluid restriction?

• A. Encourage the client to drink more fluids to stay hydrated
• B. Weigh the client daily to monitor fluid status
• C. Limit the client's intake of fruits and vegetables
• D. Monitor the client's fluid intake only during meals

Correct answer: B

Rationale: When caring for a client with heart failure on fluid restriction, weighing the client daily is crucial to monitor fluid balance accurately. This helps healthcare providers assess if the client is retaining excess fluids, which can worsen heart failure. Encouraging the client to drink more fluids (choice A) contradicts the goal of fluid restriction. Limiting intake of fruits and vegetables (choice C) is not a specific guideline for managing fluid restriction in heart failure. Monitoring fluid intake only during meals (choice D) is insufficient as fluid balance needs to be monitored consistently throughout the day.

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