Nursing Elites

1. A client is admitted for COPD. Which finding would require the nurse's immediate attention?

• A. Nausea and vomiting
• B. Restlessness and confusion
• C. Low-grade fever and cough
• D. Irritating cough and liquefied sputum

Correct answer: B

Rationale: Restlessness and confusion are signs of hypoxia and hypercapnia in a client with COPD, indicating that the client's condition may be deteriorating rapidly. Immediate attention is necessary to prevent further complications. Nausea and vomiting (Choice A) may be related to various factors but do not directly indicate respiratory distress. Low-grade fever and cough (Choice C) are common in COPD and may not require immediate intervention. Irritating cough and liquefied sputum (Choice D) are typical symptoms of COPD exacerbation but do not signal an immediate need for attention as restlessness and confusion.

2. A confused client has been placed in physical restraints by order of the healthcare provider. Which task could be assigned to an unlicensed assistive personnel (UAP)?

• A. Assist the client with activities of daily living
• B. Monitor the client's physical safety
• C. Evaluate for basic comfort needs
• D. Document mental status and muscle strength

Correct answer: A

Rationale: The correct answer is A: 'Assist the client with activities of daily living.' Unlicensed assistive personnel (UAP) can help clients with activities of daily living, such as feeding, bathing, and dressing. This task is appropriate for UAP as it does not require professional judgment. Choices B, C, and D involve monitoring safety, evaluating needs, and documenting assessments, which require a licensed nurse's professional judgment and expertise.

3. Which of the following behaviors is influenced by cultural expectations?

• A. talking openly about the details of the illness
• B. deciding whether to 'feed a cold' or 'starve a fever'
• C. taking herbal supplements to boost the immune system
• D. all of the above

Correct answer: D

Rationale: Cultural expectations can influence all the listed behaviors. Talking openly about the details of an illness may be culturally acceptable or taboo. The decision to 'feed a cold' or 'starve a fever' is often influenced by cultural beliefs and practices. Additionally, the use of herbal supplements to boost the immune system can also be shaped by cultural norms and traditions. Therefore, all the behaviors listed can be influenced by cultural expectations, making option D the correct answer. Choices A, B, and C are incorrect because cultural expectations can impact each of these behaviors.

4. In order to establish priorities in planning and implementing the occupational health program, which of the following data will the nurse need?

• A. disease trends, birth and death rates, and social environmental conditions
• B. birth and death rates
• C. disease trends
• D. social environmental conditions

Correct answer: A

Rationale: To effectively plan and implement an occupational health program, the nurse needs comprehensive data, including disease trends, birth and death rates, and social environmental conditions. This holistic approach ensures that the program addresses a wide range of health aspects impacting the target population. Option A is the correct choice as it considers multiple factors influencing occupational health. Choices B, C, and D are each individually important but do not provide the breadth of information required to establish priorities in a comprehensive occupational health program.

5. The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?

• A. Decreased anteroposterior diameter
• B. Hyperresonance on percussion
• C. Increased breath sounds
• D. Prolonged expiratory phase

Correct answer: D

Rationale: The correct answer is D: Prolonged expiratory phase. In COPD, there is airflow obstruction leading to difficulty in exhaling air. This results in a prolonged expiratory phase. Choices A, B, and C are incorrect. Decreased anteroposterior diameter is associated with conditions like barrel chest in emphysema, not COPD. Hyperresonance on percussion is typical in conditions like emphysema, not necessarily in COPD. Increased breath sounds are not a typical finding in COPD; instead, diminished breath sounds may be present due to air trapping.

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