Nursing Elites

1. What is the best method to manage fluid overload in a patient with heart failure?

• A. Administer diuretics
• B. Provide oral fluids
• C. Increase fluid intake
• D. Provide chest physiotherapy

Correct answer: A

Rationale: Administering diuretics is the best method to manage fluid overload in a patient with heart failure. Diuretics help to remove excess fluid from the body by increasing urine output, thus reducing the fluid volume in the bloodstream and tissues. Providing oral fluids (choice B) or increasing fluid intake (choice C) would exacerbate the fluid overload rather than managing it. Chest physiotherapy (choice D) is not indicated for managing fluid overload in heart failure; it is more commonly used for conditions affecting the lungs or airways.

2. A client with asthma is prescribed a corticosteroid inhaler. Which of the following instructions should the nurse include?

• A. Use the inhaler as needed for acute symptoms.
• B. Rinse the mouth after each use.
• C. Take the medication only during asthma attacks.
• D. Administer a bronchodilator after using the corticosteroid.

Correct answer: B

Rationale: The correct instruction is to rinse the mouth after each use of a corticosteroid inhaler to prevent oral candidiasis (thrush). Choice A is incorrect because corticosteroid inhalers are usually used on a regular schedule to control asthma symptoms, not just for acute symptoms. Choice C is incorrect as corticosteroid inhalers are typically used for long-term management, not just during asthma attacks. Choice D is incorrect as administering a bronchodilator after using a corticosteroid is not a standard practice and is not necessary for the effectiveness of the corticosteroid inhaler.

3. A client with asthma asks how to use a peak flow meter. Which of the following instructions should the nurse provide?

• A. Use the peak flow meter at the same time each day.
• B. Take a slow, deep breath and blow out as hard as you can.
• C. Keep a log of your peak flow readings.
• D. Perform the test before using any bronchodilators.

Correct answer: D

Rationale: The correct answer is to instruct the client to perform the peak flow test before using any bronchodilators. This is important because it provides the most accurate baseline measurement of lung function. Choice A is not necessarily crucial for the accuracy of the test. Choice B describes the technique for spirometry, not peak flow meter use. Choice C, while important for tracking trends, is not directly related to the accuracy of the initial measurement.

4. How should a healthcare provider manage a patient with a history of hypertension who is non-compliant with medication?

• A. Educate the patient on the importance of medication
• B. Reassess the patient in 6 months
• C. Refer the patient to a specialist
• D. Discontinue the medication

Correct answer: A

Rationale: Educating the patient on the importance of medication is crucial when dealing with a patient who is non-compliant with their hypertension medication. By providing information about the significance of the medication in controlling blood pressure and preventing complications, the patient may be more motivated to adhere to the prescribed treatment. Reassessing the patient in 6 months (choice B) may lead to further deterioration of the patient's condition if non-compliance continues. Referring the patient to a specialist (choice C) may be necessary in some cases but should be preceded by efforts to improve compliance. Discontinuing the medication (choice D) without addressing the non-compliance issue can have serious health consequences for the patient.

5. A nurse is caring for a client who is postoperative following a cholecystectomy. Which of the following findings should the nurse report to the provider?

• A. Blood pressure of 110/70 mm Hg
• B. Temperature of 37.2°C (99°F)
• C. Serosanguineous wound drainage
• D. Bile-colored drainage from the surgical site

Correct answer: D

Rationale: Bile-colored drainage from the surgical site can indicate a bile leak, which is an abnormal finding and should be reported. A blood pressure of 110/70 mm Hg and a temperature of 37.2°C (99°F) are within normal ranges for a postoperative client. Serosanguineous wound drainage, which is a mix of blood and serum, is expected following a surgery like cholecystectomy. Therefore, choices A, B, and C are not findings that require immediate reporting.

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