Nursing Elites

1. What is the primary intervention for a patient with a pneumothorax?

• A. Insert a chest tube
• B. Administer oxygen
• C. Monitor respiratory rate
• D. Administer analgesics

Correct answer: A

Rationale: The correct answer is to insert a chest tube. This intervention is considered the definitive treatment for a pneumothorax as it helps remove air or fluid from the pleural space, re-expanding the lung. Administering oxygen (Choice B) can be supportive but is not the primary intervention to treat a pneumothorax. Monitoring respiratory rate (Choice C) is important but does not address the underlying issue of air in the pleural space. Administering analgesics (Choice D) may help manage pain but does not treat the pneumothorax itself.

2. What are the risk factors for developing hypertension?

• A. High sodium diet and lack of physical activity
• B. Low potassium intake and excessive alcohol consumption
• C. Frequent exercise and low cholesterol diet
• D. Smoking and family history

Correct answer: A

Rationale: The correct answer is A: High sodium diet and lack of physical activity. These are established risk factors for developing hypertension as they contribute to elevated blood pressure. Choice B, low potassium intake and excessive alcohol consumption, may also impact blood pressure but are not as strongly associated with hypertension as high sodium intake and lack of physical activity. Choice C, frequent exercise and a low cholesterol diet, are actually beneficial for reducing the risk of hypertension. Choice D, smoking and family history, are more closely linked to other health conditions such as cardiovascular diseases, rather than being primary risk factors for hypertension.

3. A nurse is caring for a client who has dementia. Which of the following interventions should the nurse take to minimize the risk for injury for this client?

• A. Use a bed exit alarm system
• B. Raise all four side rails while the client is in bed
• C. Apply soft wrist restraints
• D. Dim the lights in the client's room

Correct answer: A

Rationale: The correct answer is A: Using a bed exit alarm system. A bed exit alarm alerts staff when a client with dementia attempts to leave the bed, reducing the risk of falls. Choice B is incorrect because raising all four side rails can lead to restraint-related injuries and is not recommended. Choice C is incorrect as applying wrist restraints should be avoided due to the risk of injury and decreased mobility. Choice D is incorrect as dimming the lights in the client's room does not directly address the risk of injury associated with dementia.

4. What is the correct procedure for taking a telephone order from a provider?

• A. State patient name, drug, dose, route, frequency, and read back the order
• B. State the medication and ask for a witness to listen to the order
• C. Write down the order and verify with the provider within 12 hours
• D. Have the provider verify the order during the next in-person visit

Correct answer: A

Rationale: The correct procedure for taking a telephone order from a provider is to state the patient's name, drug, dose, route, frequency, and then read back the order to ensure accuracy. This process helps in preventing errors and ensures that all relevant information is correctly documented. Choice B is incorrect because having a witness listen to the order is not a standard practice and may not guarantee accuracy. Choice C is incorrect as verifying the order within 12 hours may lead to delays in patient care. Choice D is incorrect because waiting for the provider to verify the order during the next in-person visit could result in a significant delay in administering necessary medication.

5. What is the priority in managing a client diagnosed with delirium?

• A. Administer anti-anxiety medication
• B. Identify any underlying causes of delirium
• C. Reduce environmental stimulation to calm the client
• D. Encourage deep breathing exercises

Correct answer: B

Rationale: The priority in managing a client diagnosed with delirium is to identify any underlying causes. Delirium can be caused by various factors such as infections, medications, or metabolic imbalances. By determining the root cause, healthcare providers can address the issue effectively and tailor the treatment plan accordingly. Administering anti-anxiety medication (Choice A) may help manage symptoms but does not address the underlying cause of delirium. Similarly, reducing environmental stimulation (Choice C) and encouraging deep breathing exercises (Choice D) may provide some relief, but they do not target the primary concern of identifying and addressing the underlying causes of delirium.

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