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. The nurse is caring for a child who has just returned from surgery following a tonsillectomy and adenoidectomy. Which action by the nurse is appropriate?

• A. Offer ice chips every 2 hours
• B. Place the child in a semi-Fowler's position
• C. Encourage the child to drink from a cup
• D. Observe swallowing patterns

Correct answer: D

Rationale: Observing swallowing patterns is crucial post-tonsillectomy and adenoidectomy to detect signs of bleeding. Offering ice chips instead of ice cream helps prevent throat irritation. Placing the child in a semi-Fowler's position promotes airway patency and reduces the risk of aspiration. Encouraging the child to drink from a cup instead of a straw minimizes the risk of dislodging the surgical site.

3. In which of the following settings would a community health nurse be less likely to be involved?

• A. neighborhood clinic, community clinic, or senior center
• B. physician's office with a focus on individual client care
• C. home-based care
• D. neighborhood planning board

Correct answer: B

Rationale: Community health nurses are less likely to be involved in a physician's office with a focus on individual client care because their role primarily revolves around promoting and maintaining the health of populations and communities rather than providing direct care to individual clients. Options A, C, and D are more aligned with the community health nurse's role as they involve working in community-based settings, providing home-based care, and participating in community planning and advocacy.

4. What is the focus of health promotion activities?

• A. Treating existing health conditions
• B. Preventing the onset of disease
• C. Providing palliative care
• D. Conducting clinical trials

Correct answer: B

Rationale: The correct answer is B: Preventing the onset of disease. Health promotion activities aim to prevent illnesses and promote overall well-being through education, lifestyle changes, and preventive measures. Choice A is incorrect as health promotion is not primarily about treating existing health conditions but rather preventing them. Choice C is incorrect because palliative care focuses on providing relief and comfort to patients with serious illnesses, not on preventing diseases. Choice D is also incorrect as conducting clinical trials is a research activity to test new treatments or interventions, not a focus of health promotion.

5. The client with Parkinson's disease spends over 1 hour to dress for scheduled therapies. What is the most appropriate action for the nurse to take in this situation?

• A. Ask family members to dress the client
• B. Encourage the client to dress more quickly
• C. Allow the client the time needed to dress
• D. Demonstrate methods on how to dress more quickly

Correct answer: C

Rationale: The most appropriate action for the nurse is to allow the client the time needed to dress. Patients with Parkinson's disease may experience difficulties with activities of daily living due to their condition. Allowing the client sufficient time to dress promotes independence and dignity, which are essential aspects of patient-centered care. Asking family members to dress the client may undermine the client's autonomy and self-esteem. Encouraging the client to dress more quickly may lead to frustration and feelings of inadequacy. Demonstrating methods on how to dress more quickly may not address the underlying challenges the client faces and could be perceived as insensitive or dismissive of the client's needs.

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