Nursing Elites

1. A healthcare provider is caring for a client who has asthma and is experiencing wheezing. Which of the following medications should the healthcare provider administer?

• A. Fluticasone
• B. Montelukast
• C. Albuterol
• D. Ipratropium

Correct answer: C

Rationale: Albuterol is a short-acting beta-agonist bronchodilator used to quickly relieve bronchospasm in clients with asthma who are experiencing wheezing. Fluticasone is an inhaled corticosteroid used for long-term control of asthma symptoms and not for acute wheezing. Montelukast is a leukotriene receptor antagonist used for long-term asthma management, not for immediate relief of wheezing. Ipratropium is an anticholinergic bronchodilator used for chronic obstructive pulmonary disease (COPD) and not typically used as the first-line treatment for asthma exacerbation.

2. A nurse is planning to teach a group of clients about preventing low back pain. Which of the following information should the nurse include?

• A. Wear low-heeled shoes.
• B. Elevate the legs while sitting.
• C. Engage in prolonged sitting to rest the back muscles.
• D. Sleep on a soft mattress to prevent strain on the back.

Correct answer: A

Rationale: The correct answer is A: 'Wear low-heeled shoes.' Wearing low-heeled shoes helps prevent back strain by promoting proper posture. High heels can cause an imbalance in the body's alignment, leading to increased stress on the lower back. Choices B, C, and D are incorrect. Elevating the legs while sitting can help with circulation but does not directly prevent low back pain. Engaging in prolonged sitting can actually contribute to low back pain due to decreased muscle activity and increased pressure on the spine. Sleeping on a soft mattress may not provide adequate support for the back, potentially worsening back pain instead of preventing it.

3. A client with type 1 diabetes mellitus is being taught self-administration of insulin by a nurse. Which of the following instructions should the nurse include?

• A. Inject air into the vial before withdrawing the insulin.
• B. Draw up the short-acting insulin first, then the long-acting insulin.
• C. Store unopened insulin vials in the freezer.
• D. Rotate injection sites within the same anatomical region.

Correct answer: D

Rationale: The correct instruction the nurse should include is to rotate injection sites within the same anatomical region. This practice helps reduce the risk of lipodystrophy, a condition characterized by fatty tissue changes due to repeated insulin injections in the same spot. By rotating sites, the client ensures better insulin absorption and prevents localized skin changes. Injecting air into the vial before withdrawing insulin (Choice A) is unnecessary and not recommended. Drawing up short-acting insulin before long-acting insulin (Choice B) is not a standard practice and can lead to errors in dosing. Storing unopened insulin vials in the freezer (Choice C) is incorrect as insulin should be stored in the refrigerator, not the freezer, to maintain its effectiveness.

4. A nurse is assessing a client who is 1 hour postoperative following a hysterectomy. Which of the following findings should the nurse report to the provider?

• A. Heart rate of 78/min.
• B. Blood pressure of 120/80 mm Hg.
• C. Oxygen saturation of 94%.
• D. Respiratory rate of 16/min.

Correct answer: A

Rationale: A heart rate of 78/min is within the normal range; however, postoperative patients require close monitoring for any signs of complications. While the heart rate is normal, other critical findings such as increased pain, excessive bleeding, or other concerning symptoms may need immediate attention. Choices B, C, and D all indicate normal postoperative vital signs and oxygen saturation levels, which do not raise immediate concerns requiring reporting to the provider.

5. A nurse is caring for a client who is at risk for pressure ulcers. Which of the following interventions should the nurse implement?

• A. Turn the client every 2 hours
• B. Use a donut-shaped cushion when sitting
• C. Elevate the head of the bed to 45 degrees
• D. Massage reddened areas to increase circulation

Correct answer: A

Rationale: The correct intervention for preventing pressure ulcers in a client at risk is to turn the client every 2 hours. This helps relieve pressure on bony prominences, improving circulation and preventing tissue damage. Using a donut-shaped cushion can actually increase pressure on the skin and worsen the risk of pressure ulcers. Elevating the head of the bed to 45 degrees is beneficial for preventing aspiration in some cases but does not directly address pressure ulcer prevention. Massaging reddened areas can further damage the skin and increase the risk of pressure ulcer development by causing friction and shearing forces.

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