Nursing Elites

1. When a client expresses, 'I don't know how I will go on' while discussing feelings related to a recent loss, the nurse remains silent. What is the most likely reason for the nurse's behavior?

• A. The nurse is indicating disapproval of the statement.
• B. The nurse is showing respect for the client's loss.
• C. Silence is mirroring the client's sadness.
• D. Silence enables the client to contemplate what was expressed.

Correct answer: D

Rationale: In therapeutic communication, silence can offer the client an opportunity to process their emotions and thoughts. By remaining silent, the nurse provides a space for the client to reflect on their own words, facilitating deeper exploration and understanding of their feelings.

2. What is the primary action of a short-acting beta2-agonist (SABA) prescribed to a patient with an acute asthma exacerbation?

• A. Reduce inflammation
• B. Relieve bronchospasm
• C. Thin respiratory secretions
• D. Suppress cough

Correct answer: B

Rationale: The correct answer is B: Relieve bronchospasm. The primary action of short-acting beta2-agonists (SABAs) is to relieve bronchospasm. These medications are bronchodilators that work by opening the airways, making breathing easier for patients experiencing asthma exacerbations. By relieving bronchospasm, SABAs help improve airflow and alleviate symptoms of asthma such as wheezing and shortness of breath. Choices A, C, and D are incorrect because SABAs do not primarily reduce inflammation, thin respiratory secretions, or suppress cough. While these actions may be part of asthma management, the immediate goal of using a SABA during an acute exacerbation is to quickly relieve bronchospasm and improve airflow.

3. A client with a history of myocardial infarction (MI) is prescribed atorvastatin (Lipitor). Which outcome indicates that the medication is effective?

• A. Increased blood pressure.
• B. Lowered cholesterol levels.
• C. Decreased heart rate.
• D. Improved liver function.

Correct answer: B

Rationale: The correct answer is B: Lowered cholesterol levels. Atorvastatin is a medication commonly prescribed to lower cholesterol levels, which is crucial in reducing the risk of further cardiovascular events, including myocardial infarction (MI). Monitoring cholesterol levels is essential to assess the effectiveness of atorvastatin therapy and its role in preventing future cardiac complications. Choices A, C, and D are incorrect because increased blood pressure, decreased heart rate, and improved liver function are not direct indicators of atorvastatin's effectiveness in a client with a history of MI.

4. A healthcare provider is preparing to administer a scheduled dose of intravenous (IV) metoprolol (Lopressor) to a client. The client's apical pulse is 58 beats/minute. What action should the healthcare provider take?

• A. Administer the medication as prescribed.
• B. Hold the medication and notify the healthcare provider.
• C. Give half the prescribed dose and recheck the pulse in 30 minutes.
• D. Administer the medication and then recheck the pulse in 30 minutes.

Correct answer: B

Rationale: In the scenario described, with the client's apical pulse being 58 beats/minute, holding the medication and notifying the healthcare provider is the correct action. A low pulse rate may indicate bradycardia and may necessitate dose adjustment or further evaluation by the healthcare provider to prevent potential complications.

5. A 35-year-old man presents with difficulty swallowing, weight loss, and regurgitation of undigested food. A barium swallow shows a 'bird beak' appearance of the lower esophagus. What is the most likely diagnosis?

• A. Esophageal cancer
• B. Achalasia
• C. Peptic stricture
• D. Gastroesophageal reflux disease

Correct answer: B

Rationale: The 'bird beak' appearance on a barium swallow is characteristic of achalasia, a condition where the lower esophageal sphincter fails to relax properly. This leads to difficulty swallowing, weight loss, and regurgitation of undigested food, which are hallmark symptoms of achalasia.

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