Nursing Elites

1. What are the signs and symptoms of a pulmonary embolism?

• A. Sudden shortness of breath
• B. Chest pain
• C. Cough with blood
• D. All of the above

Correct answer: D

Rationale: A pulmonary embolism can manifest with sudden shortness of breath, chest pain, and coughing up blood. These symptoms are classic presentations of a pulmonary embolism due to the blockage of blood flow to the lungs. Therefore, the correct answer is 'All of the above.' Each symptom alone can be seen in various other conditions, but when occurring together, they strongly suggest a pulmonary embolism. Sudden shortness of breath is due to decreased oxygenation, chest pain can result from the strain on the heart, and coughing with blood may indicate damage to the lung tissue. Choosing any single symptom would not encompass the full range of presentations seen in a pulmonary embolism.

2. A nurse in a long-term care facility is serving on the ethics committee, which is addressing a client care dilemma. Which of the following strategies will facilitate resolving the dilemma?

• A. Ensure client autonomy only
• B. Consider only medical benefits
• C. Ensure clear communication among the health care team
• D. Identify possible solutions

Correct answer: D

Rationale: In resolving ethical dilemmas, it is essential to identify possible solutions to address the client care dilemma effectively. Option A, 'Ensure client autonomy only,' is not comprehensive enough to resolve complex ethical issues. Option B, 'Consider only medical benefits,' overlooks other important factors beyond medical benefits that are involved in ethical decision-making. Option C, 'Ensure clear communication among the health care team,' is important but may not be sufficient on its own to resolve the ethical dilemma. Therefore, the most effective strategy among the given options is to identify possible solutions to navigate through the ethical dilemma.

3. How should a healthcare professional manage a patient with suspected myocardial infarction (MI)?

• A. Administer oxygen and call for emergency help
• B. Monitor vital signs and provide pain relief
• C. Provide nitroglycerin and thrombolytics
• D. Administer diuretics and provide a high-protein diet

Correct answer: A

Rationale: Administering oxygen and seeking emergency help are crucial initial steps in managing a patient with suspected myocardial infarction (MI). Oxygen helps to improve oxygenation to the heart muscle, reducing its workload and preventing further damage. Calling for emergency help ensures timely access to advanced medical care, including interventions like thrombolytics. Monitoring vital signs and providing pain relief are important but secondary to the immediate need for oxygen and emergency assistance. Providing nitroglycerin and thrombolytics should be done under medical supervision and following appropriate protocols, not as the first step. Administering diuretics and altering the patient's diet are not indicated in the acute management of MI.

4. What are the complications of untreated pneumonia?

• A. Sepsis and respiratory failure
• B. Heart failure and kidney failure
• C. Pulmonary embolism and electrolyte imbalance
• D. Liver failure and electrolyte imbalance

Correct answer: A

Rationale: The correct answer is A: Sepsis and respiratory failure. Untreated pneumonia can lead to severe complications such as sepsis, which is a life-threatening response to infection, and respiratory failure, where the lungs can no longer provide enough oxygen to the body. Heart failure and kidney failure (choice B) are not direct complications of untreated pneumonia. Pulmonary embolism and electrolyte imbalance (choice C) are also not commonly associated with untreated pneumonia. Liver failure and electrolyte imbalance (choice D) are not typical complications of pneumonia.

5. A healthcare professional is preparing to discharge a client who is immunocompromised. Which of the following vaccines should the professional plan to administer?

• A. Varicella
• B. Influenza
• C. Hepatitis B
• D. Pneumococcal polysaccharide

Correct answer: D

Rationale: Immunocompromised clients have weakened immune systems, making them more susceptible to infections. The pneumococcal polysaccharide vaccine is recommended for these individuals to help prevent pneumococcal infections, which can be severe and life-threatening. Varicella, Influenza, and Hepatitis B vaccines are not specifically indicated for immunocompromised clients. Varicella contains a live virus that can cause infections in immunocompromised individuals. Influenza is generally recommended for all individuals over 6 months of age but does not have the same priority as the pneumococcal vaccine for immunocompromised clients. Hepatitis B vaccine is crucial for preventing Hepatitis B infection but is not directly related to the increased infection risk faced by immunocompromised clients.

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