Nursing Elites

1. When performing postural drainage on a client with chronic obstructive pulmonary disease (COPD), which approach should the nurse use?

• A. Obtain arterial blood gases (ABGs) before the procedure.
• B. Explain that the client may be positioned in five different ways.
• C. Assist the patient into a position that will allow gravity to move secretions.
• D. Encourage the client to practice deep breathing throughout the procedure.

Correct answer: C

Rationale: The correct approach when performing postural drainage on a client with COPD is to assist the patient into a position that allows gravity to help move secretions. This position helps drain secretions from specific segments of the lungs. Obtaining arterial blood gases (Choice A) is not directly related to postural drainage. While the client may be placed in multiple positions during postural drainage, the key is to position them to facilitate the movement of secretions, not just any five positions as mentioned in Choice B. Encouraging deep breathing (Choice D) is a good nursing intervention for overall respiratory health but is not specifically related to the technique of postural drainage.

2. A woman with chronic osteoarthritis is complaining of knee pain. Which pathophysiological process is contributing to her pain?

• A. Inflammation of the synovial membrane.
• B. Degeneration of the cartilage in the joint.
• C. Joint inflammation occurs when chondrocyte injury destroys joint cartilage, producing osteophytes.
• D. Formation of uric acid crystals in the joint space.

Correct answer: C

Rationale: The correct answer is C. In osteoarthritis, the breakdown of cartilage in the joints leads to chondrocyte injury, which results in the destruction of joint cartilage and the production of osteophytes. This process causes joint inflammation and pain. Choice A is incorrect because osteoarthritis primarily involves the articular cartilage rather than the synovial membrane. Choice B is incorrect as it describes the degeneration of cartilage but does not explain the specific pathophysiological process contributing to pain in osteoarthritis. Choice D is incorrect as the formation of uric acid crystals is characteristic of gout, not osteoarthritis.

3. A female client who was involved in a motor vehicle collision is admitted with a fractured left femur which is immobilized using a fracture traction splint in preparation for an open reduction internal fixation (ORIF). The nurse determines that her distal pulses are diminished in the left foot. Which interventions should the nurse implement? (Select all that apply)

• A. Verify pedal pulses using a doppler pulse device.
• B. Monitor left leg for pain, pallor, paresthesia, paralysis, pressure.
• C. Evaluate the application of the splint to the left leg.
• D.

Correct answer: C

Rationale: It is crucial for the nurse to evaluate the application of the splint to the left leg in a client with diminished distal pulses. This assessment helps ensure that the splint is not causing any compromise to circulation. Verifying pulses and monitoring for leg conditions are important interventions but do not directly address the issue with the splint application in this scenario, making them less relevant.

4. A client with a new colostomy is concerned about odor. What is the best advice the nurse can provide?

• A. Avoid high-fiber foods
• B. Use an odor-proof pouch
• C. Decrease fluid intake
• D. Increase dairy products in the diet

Correct answer: B

Rationale: The best advice the nurse can provide to a client concerned about odor from a new colostomy is to use an odor-proof pouch. This option helps control odors effectively by containing and masking any unpleasant smells. Avoiding high-fiber foods (Choice A) is not the best advice as fiber is essential for bowel health, and decreasing fluid intake (Choice C) can lead to dehydration and other complications. Increasing dairy products in the diet (Choice D) is not directly related to controlling odors from a colostomy.

5. What is a priority action for the nurse when caring for a client with suspected meningitis?

• A. Isolate the client in a private room
• B. Administer intravenous antibiotics
• C. Obtain a throat culture
• D. Perform a chest x-ray

Correct answer: B

Rationale: Administering intravenous antibiotics is the priority when caring for a client with suspected meningitis. The prompt administration of antibiotics is crucial to treat bacterial meningitis and prevent potential complications. Isolating the client in a private room may be necessary to prevent the spread of infection, but antibiotic administration takes precedence. Obtaining a throat culture and performing a chest x-ray are important diagnostic measures, but they do not address the immediate need for antibiotic therapy in suspected bacterial meningitis.

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