Nursing Elites

1. Which of the following medications is typically used to treat asthma?

• A. Aspirin
• B. Metformin
• C. Albuterol
• D. Lisinopril

Correct answer: C

Rationale: The correct answer is C, Albuterol. Albuterol is a bronchodilator commonly used to treat asthma by relaxing the muscles around the airways, helping to relieve symptoms such as coughing, wheezing, shortness of breath, and chest tightness. Aspirin (Choice A) is not typically used to treat asthma and can actually trigger asthma symptoms in some individuals. Metformin (Choice B) is a medication for managing type 2 diabetes and is not indicated for asthma treatment. Lisinopril (Choice D) is an angiotensin-converting enzyme (ACE) inhibitor primarily used to treat high blood pressure and heart failure, not asthma.

2. The nurse is caring for a client who is postoperative for a femoral head fracture repair. Which intervention(s) should the nurse plan to administer for deep vein thrombosis prophylaxis?

• A. Pneumatic compression devices
• B. Incentive spirometry
• C. Assisted ambulation
• D. Calf-pump exercises

Correct answer: A

Rationale: The correct intervention for deep vein thrombosis prophylaxis in a postoperative client with a femoral head fracture repair is the use of pneumatic compression devices. These devices help prevent stasis in the lower extremities by promoting venous return through intermittent compression. Incentive spirometry is used to prevent respiratory complications by promoting lung expansion and clearing secretions, not for DVT prophylaxis. Assisted ambulation and calf-pump exercises are beneficial for promoting circulation and preventing DVT, but pneumatic compression devices are more effective in this specific postoperative scenario.

3. A client is brought to the emergency department by a neighbor. The client is lethargic and has a fruity odor on the breath. The client’s arterial blood gas (ABG) results are pH 7.25, PCO2 34 mm Hg, PO2 86 mm Hg, HCO3 14 mEq/L. Which of the following acid-base disturbances does the nurse recognize in these results?

• A. Metabolic acidosis
• B. Metabolic alkalosis
• C. Respiratory acidosis
• D. Respiratory alkalosis

Correct answer: A

Rationale: The correct answer is 'Metabolic acidosis.' Metabolic acidosis is characterized by a low pH (<7.35) and a low bicarbonate level (HCO3 <22 mEq/L). In this case, the client's ABG results show a pH of 7.25 and an HCO3 level of 14 mEq/L, indicating metabolic acidosis. The PCO2 of 34 mm Hg is normal, ruling out respiratory acidosis or alkalosis. The PO2 of 86 mm Hg is also within the normal range and is not indicative of a respiratory problem. Therefore, the client is experiencing metabolic acidosis based on the ABG results provided.

4. A client is to have a transsphenoidal hypophysectomy to remove a large, invasive pituitary tumor. The nurse should instruct the client that the surgery will be performed through an incision in the:

• A. Back of the mouth.
• B. Nose.
• C. Sinus channel below the right eye.
• D. Upper gingival mucosa in the space between the upper gums and lip.

Correct answer: D

Rationale: The correct answer is D: Upper gingival mucosa in the space between the upper gums and lip. A transsphenoidal hypophysectomy involves accessing the pituitary gland through an incision in the upper gingival mucosa, providing direct access to the pituitary gland without external scars. Choices A, B, and C are incorrect because the surgery is not performed through the back of the mouth, the nose, or the sinus channel below the right eye. It is crucial for the client to understand the specific location of the incision to ensure accurate preoperative education and expectations.

5. A client recently diagnosed with chronic kidney disease (CKD) is receiving discharge instructions from a nurse. Which statements made by the client indicate a correct understanding of the teaching? (Select all that apply.)

• A. I need to ask for an antibiotic when scheduling a dental appointment.
• B. I’ll need to check my blood sugar often to prevent hypoglycemia.
• C. The dose of my pain medication may have to be adjusted.
• D. The need to watch for bleeding with anticoagulants.

Correct answer: A

Rationale: The correct statements indicating a proper understanding of the teaching include the need for antibiotics for dental work, the potential need to adjust pain medication doses, and the importance of monitoring blood sugar levels. The statement about watching for bleeding with anticoagulants is not directly related to CKD and discharge instructions for this condition. Therefore, option A is correct, as it addresses relevant concerns for a client with CKD, while the other options are either unrelated or not specifically mentioned in the scenario.

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