Nursing Elites

1. What causes the appearance of a barrel chest in clients with emphysema?

• A. Peripheral edema
• B. Bacterial infections in the lungs
• C. Air trapping in the alveoli
• D. Muscle atrophy of the diaphragm

Correct answer: C

Rationale: The correct answer is C: Air trapping in the alveoli. A barrel chest in emphysema results from the hyperinflation of the lungs due to air trapping in the alveoli. This leads to increased anteroposterior diameter of the chest. Choices A, B, and D are incorrect. Peripheral edema is swelling caused by fluid retention in tissues, not associated with a barrel chest in emphysema. Bacterial infections in the lungs can lead to conditions like pneumonia but do not directly cause a barrel chest. Muscle atrophy of the diaphragm could affect breathing mechanics but is not specifically linked to the development of a barrel chest in emphysema.

2. What specific instructions should the nurse provide for a patient starting on alendronate (Fosamax) for osteoporosis to ensure proper administration?

• A. Take the medication with a full glass of water and remain upright for at least 30 minutes.
• B. Take the medication with milk to enhance calcium absorption.
• C. Take the medication at bedtime to ensure absorption during sleep.
• D. Take the medication with food to prevent nausea.

Correct answer: A

Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. Choice B is incorrect because alendronate should not be taken with milk, as it can interfere with its absorption. Choice C is incorrect as there is no specific instruction to take alendronate at bedtime. Choice D is incorrect because alendronate should be taken on an empty stomach, not with food, to enhance absorption.

3. Which ability should Nurse Rebecca expect from a client in the mild stage of dementia of the Alzheimer’s type?

• A. Remembering the daily schedule
• B. Recalling past events
• C. Coping with anxiety
• D. Solving problems of daily living

Correct answer: B

Rationale: In the mild stage of dementia of the Alzheimer’s type, clients can often recall past events but may have difficulty with new information. Therefore, Nurse Rebecca should expect the client to have the ability to recall past events. Choice A is incorrect because remembering the daily schedule may become challenging as the disease progresses. Choice C is incorrect as clients in the mild stage may experience anxiety, but coping with anxiety is not a specific ability associated with this stage of dementia. Choice D is incorrect as solving problems of daily living becomes more challenging as the disease advances, not in the mild stage.

4. A woman is complaining that she feels like the room is spinning even though she is not moving. Which of the following is characteristic of benign positional vertigo?

• A. It usually occurs with a headache.
• B. Pupillary changes are common.
• C. It is usually triggered when the patient bends forward.
• D. Nystagmus continues even when eyes fixate on an object.

Correct answer: C

Rationale: Benign positional vertigo is typically triggered by changes in head position, such as bending forward or turning over in bed. This change in position leads to brief episodes of vertigo, often associated with nystagmus, which is rapid, involuntary eye movements. Pupillary changes and headaches are not typical features of benign positional vertigo, making choices B and A incorrect. Nystagmus in benign positional vertigo usually stops when the eyes fixate on an object, so choice D is also incorrect.

5. A 50-year-old woman has had a relapse of her multiple sclerosis (MS) after several years of being symptom-free. Which of the following factors is most likely to have contributed to her relapse?

• A. Emotional stress
• B. Dietary indiscretion
• C. Physical overexertion
• D. Adequate rest and relaxation

Correct answer: C

Rationale: The correct answer is C: Physical overexertion. In individuals with multiple sclerosis (MS), physical overexertion can exacerbate symptoms and contribute to a relapse. It is important for individuals with MS to balance physical activity to avoid triggering symptom reoccurrence. Choices A, B, and D are less likely to have directly contributed to the relapse. Emotional stress and dietary indiscretion may play a role in exacerbating symptoms in some individuals, but physical overexertion is more commonly associated with MS relapses. Adequate rest and relaxation are important for overall well-being but are not typically linked to MS relapses.

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