Nursing Elites

1. A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding indicates the condition is worsening?

• A. Increased shortness of breath
• B. Decreased wheezing
• C. Productive cough with green sputum
• D. Slight increase in fatigue

Correct answer: A

Rationale: The correct answer is A: Increased shortness of breath. In COPD, worsening symptoms often include increased shortness of breath due to impaired lung function. This indicates a decline in respiratory status and the need for prompt intervention. Choice B, decreased wheezing, is not indicative of worsening COPD as it could suggest better airflow. Choice C, productive cough with green sputum, may indicate an infection but not necessarily worsening COPD. Choice D, a slight increase in fatigue, is non-specific and may not directly correlate with the worsening of COPD.

2. What is the recommended procedure for a healthcare professional to follow when applying sterile gloves?

• A. Use non-sterile gloves first, followed by sterile gloves.
• B. Put on sterile gloves, then gown.
• C. Apply gloves after donning a mask.
• D. Apply gloves before touching any sterile equipment.

Correct answer: D

Rationale: The correct procedure for applying sterile gloves is to do so before touching any sterile equipment or surfaces. This helps maintain the sterility of the gloves. Choices A, B, and C are incorrect because they suggest incorrect sequences that may compromise the sterility of the gloves. Using non-sterile gloves first can introduce contamination, putting on gloves before a gown can lead to contamination of the gloves during gowning, and applying gloves after donning a mask can risk contamination of the gloves from the mask.

3. A nurse is observing a patient's use of a walker. Which observation indicates a need for further teaching?

• A. The patient advances the walker too far ahead.
• B. The patient uses the walker to assist in standing.
• C. The patient maintains their balance while using the walker.
• D. The patient walks with their back hunched over.

Correct answer: A

Rationale: The correct answer is A because advancing the walker too far ahead increases the risk of falls, indicating a need for further teaching. Choice B is correct as using the walker to assist in standing is a proper use. Choice C is correct as maintaining balance while using the walker shows proper technique. Choice D is incorrect as walking with the back hunched over is a posture issue, not directly related to walker use.

4. A client with a new prescription for sumatriptan tablets to treat migraine headaches should report which of the following symptoms to the nurse?

• A. Chew the tablet well before swallowing
• B. Report swelling of the eyelids after dosage
• C. Repeat dose in 1 hour for unrelieved headache
• D. Take daily to prevent headaches

Correct answer: B

Rationale: The correct answer is B because swelling of the eyelids is a side effect of sumatriptan tablets that requires immediate reporting to the healthcare provider to prevent further complications. Choices A, C, and D are incorrect. Chewing the tablet well before swallowing is not necessary for sumatriptan tablets. Repeating the dose in 1 hour for unrelieved headache is incorrect as this medication should not be repeated within 24 hours. Taking sumatriptan daily for headache prevention is also incorrect as it is used for acute treatment, not prevention.

5. Which action by the nurse will help prevent ventilator-associated pneumonia (VAP) in a patient on mechanical ventilation?

• A. Provide oral care every 4 hours.
• B. Reposition the patient every 2 hours.
• C. Suction the patient as needed.
• D. Administer antibiotics as prescribed.

Correct answer: A

Rationale: The correct answer is A. Providing oral care every 4 hours helps prevent ventilator-associated pneumonia by reducing the buildup of bacteria in the mouth that can be aspirated into the lungs. Repositioning the patient every 2 hours is important for preventing pressure ulcers but is not directly related to preventing VAP. Suctioning the patient as needed is essential for maintaining airway patency but does not specifically prevent VAP. Administering antibiotics as prescribed is a treatment for infections but does not prevent VAP.

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