Nursing Elites

1. Mr. B is recovering from a surgical procedure that was performed four days ago. The nurse's assessment finds this client coughing up rust-colored sputum; his respiratory rate is 28/minute with expiratory grunting, and his lung sounds have coarse crackles on auscultation. Which of the following conditions is the most likely cause of these symptoms?

• A. Tuberculosis
• B. Pulmonary edema
• C. Pneumonia
• D. Histoplasmosis

Correct answer: C

Rationale: In this scenario, the client's presentation of coughing up rust-colored sputum, increased respiratory rate, expiratory grunting, and coarse crackles on lung auscultation suggests the development of pneumonia. Pneumonia is characterized by lung tissue inflammation or infection, often caused by various organisms. Symptoms may include productive cough, dyspnea, and abnormal breath sounds. Tuberculosis (Choice A) typically presents with a chronic cough, weight loss, and night sweats and is less likely in this acute post-operative setting. Pulmonary edema (Choice B) is characterized by pink, frothy sputum, crackles throughout the lungs, and typically occurs in the context of heart failure. Histoplasmosis (Choice D) is a fungal infection that usually presents with flu-like symptoms and is less likely to manifest with the specific respiratory findings described in this case.

2. While working with an obese adolescent, it is important for the nurse to recognize that obesity in adolescents is most often associated with what other behavior?

• A. Sexual promiscuity
• B. Poor body image
• C. Dropping out of school
• D. Drug experimentation

Correct answer: B

Rationale: When addressing obesity in adolescents, it is crucial to consider that poor body image is a common behavior associated with obesity. As adolescents gain weight, they may experience a decrease in self-esteem and a negative perception of their body. This can contribute to a cycle of unhealthy behaviors and impact their overall well-being. The other choices are less commonly associated with obesity in adolescents. Sexual promiscuity may be influenced by various factors unrelated to obesity, dropping out of school is more often linked to academic challenges or social issues, and drug experimentation can stem from a range of influences but is not directly correlated with obesity.

3. Which factors will the nurse consider when calculating the CURB-65 score for a patient with pneumonia? (Select one that does not apply)

• A. Age
• B. Blood pressure
• C. Respiratory rate
• D. Oxygen saturation

Correct answer: D

Rationale: The correct answer is 'Oxygen saturation.' When calculating the CURB-65 score for a patient with pneumonia, the factors considered include mental status (confusion), BUN (elevated), blood pressure (decreased), respiratory rate (increased), and age (65 and older). Oxygen saturation is not used in the CURB-65 scoring system. While blood pressure, respiratory rate, and age are factors that are used in the calculation of the CURB-65 score, oxygen saturation is not part of the scoring criteria. Therefore, oxygen saturation is the factor that does not apply when calculating the CURB-65 score.

4. A patient in the cardiac care unit is taking bumetanide (Bumex) for heart issues and is also diagnosed with Parkinson's Disease. An unlicensed assistive personnel is assisting with feeding the patient. Which of these foods should the nurse stress for the patient to eat most?

• A. Foods containing the least amount of salt
• B. Foods containing the most amount of potassium
• C. Foods containing the most amount of calories
• D. Foods containing the most amount of fiber

Correct answer: B

Rationale: Bumex is a loop diuretic that can lead to hypokalemia (low potassium levels). Hypokalemia can be dangerous and lead to various complications. To prevent a hypokalemic crisis, it is crucial to ensure an adequate intake of potassium. Therefore, the nurse should stress the patient to eat foods rich in potassium. Choices A, C, and D are not the priority in this situation. While monitoring salt intake is important in cardiac patients, the immediate concern with bumetanide use is the risk of hypokalemia, making choice B the most appropriate option.

5. Which of the following complaints is characteristic of a patient with Bell's Palsy?

• A. Paralysis of the right or left arm
• B. Malfunction of a certain cranial nerve
• C. A sub-condition of Cerebral Palsy
• D. A side effect of a stroke

Correct answer: B

Rationale: Bell's Palsy is characterized by the dysfunction of the Facial nerve, which is cranial nerve VII. This dysfunction leads to facial muscle weakness or paralysis, not affecting the arms. Choice A is incorrect as Bell's Palsy specifically involves facial muscles, not the arms. Choice C is incorrect as it incorrectly associates Bell's Palsy with a different condition, Cerebral Palsy. Choice D is incorrect as Bell's Palsy is not a side effect of a stroke but rather a distinct condition with its own etiology.

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