Nursing Elites

1. Which of the following patients is at greatest risk for developing pressure ulcers?

• A. An alert chronic arthritic patient treated with steroids and aspirin
• B. An 88-year-old incontinent patient with gastric cancer who is confined to bed at home
• C. An apathetic 63-year-old COPD patient receiving nasal oxygen via cannula
• D. A confused 78-year-old patient with congestive heart failure (CHF) who requires assistance to get out of bed

Correct answer: B

Rationale: The correct answer is B. An elderly patient who is incontinent, bedridden, and suffering from a serious illness like gastric cancer is at the highest risk for developing pressure ulcers. Being bedridden and incontinent increases the pressure on certain areas of the body, leading to tissue damage and the development of pressure ulcers. Additionally, the patient's age and underlying health condition further contribute to their risk. It is crucial to identify and address such risk factors promptly to prevent the occurrence of pressure ulcers in vulnerable patients.

2. Which of the following white blood cell (WBC) counts clearly indicates leukocytosis?

• A. 4,500/mm³
• B. 7,000/mm³
• C. 10,000/mm³
• D. 25,000/mm³

Correct answer: D

Rationale: Leukocytosis is defined as an increase in the total white blood cell count. A normal WBC count typically ranges from 4,500 to 10,000/mm³. A WBC count of 25,000/mm³, as indicated in choice D, is significantly higher than the normal range and clearly indicates leukocytosis.

3. When planning care for a client with severe acute respiratory distress syndrome (SARS), which of the following actions should not be included in the care plan?

• A. Administer antibiotics
• B. Provide supplemental oxygen
• C. Administer antiviral medications
• D. Administer bronchodilators

Correct answer: A

Rationale: Severe acute respiratory distress syndrome (SARS) is caused by a virus, not bacteria, and antibiotics are ineffective against viral infections. Therefore, administering antibiotics would not be appropriate in the care plan for a client with SARS. The priority interventions for SARS include providing supplemental oxygen to improve oxygenation, administering antiviral medications to target the viral infection, and using bronchodilators to help with bronchospasm or airway constriction. Antibiotics are not indicated unless there is a secondary bacterial infection present.

4. Which of the following techniques involves the sense of sight?

• A. Inspection
• B. Palpation
• C. Percussion
• D. Auscultation

Correct answer: A

Rationale: The correct answer is Inspection (Choice A). Inspection is a technique that involves observing the patient using the sense of sight. During inspection, a healthcare provider visually examines the patient for any abnormalities, changes, or specific signs that may help in diagnosing a condition. Palpation (Choice B) involves using the sense of touch to feel for abnormalities. Percussion (Choice C) involves tapping the body to produce sounds that can help identify the underlying structures. Auscultation (Choice D) involves listening to sounds produced by the body, typically using a stethoscope. Therefore, in this context, the technique that specifically involves the sense of sight is Inspection.

5. When teaching a client with tuberculosis, which statement should the nurse include?

• A. You will need to continue taking the multi-medication regimen for 4 months.
• B. You will need to provide sputum samples every 4 weeks to monitor the effectiveness of the medication.
• C. You will need to remain hospitalized for treatment.
• D. You will need to wear a mask at all times.

Correct answer: B

Rationale: Monitoring the effectiveness of tuberculosis medication is crucial to ensure the treatment is working properly. Regular sputum samples help in assessing the response to the medication. This monitoring can guide adjustments in the treatment plan if needed. Options A and C are incorrect as they do not reflect essential aspects of tuberculosis treatment. Option D is not a standard recommendation for tuberculosis treatment and may lead to misconceptions.

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