Nursing Elites

1. A client has developed a pulmonary embolism. Which of the following interventions should the nurse implement first?

• A. Administer oxygen
• B. Prepare the client for a thoracentesis
• C. Elevate the client’s lower extremities
• D. Administer anticoagulant therapy

Correct answer: A

Rationale: Administering oxygen is the priority intervention for a client with a pulmonary embolism. Pulmonary embolism can lead to impaired gas exchange, causing hypoxemia. Administering oxygen helps to maintain adequate oxygenation levels. Thoracentesis is not indicated for a pulmonary embolism, as it is a procedure to remove fluid or air from the pleural space, not a treatment for embolism. Elevating the client's lower extremities is not a priority in the management of a pulmonary embolism. Administering anticoagulant therapy is important in the treatment of pulmonary embolism to prevent further clot formation, but it is not the first intervention. Oxygen administration takes precedence to address the immediate oxygenation needs of the client.

2. A healthcare professional is preparing to administer a dose of naloxone. Which of the following should the healthcare professional assess?

• A. Heart rate
• B. Respiratory rate
• C. Blood pressure
• D. Temperature

Correct answer: B

Rationale: Correct. Naloxone is used to reverse opioid overdose, which can cause respiratory depression. Assessing the respiratory rate before administering naloxone is crucial to monitor the patient's breathing. Choices A, C, and D are important assessments in general patient care but are not specifically crucial before administering naloxone for opioid overdose.

3. When designing a program for young adults regarding safe sexual practices, which strategy might reach the greatest number in the target group?

• A. Web-based applications
• B. Print-based media such as newspapers
• C. Television advertisements
• D. Brochures in kiosks in malls

Correct answer: A

Rationale: Web-based applications are the most effective strategy for reaching young adults in the target group regarding safe sexual practices. Young adults today are highly engaged with mobile technology and the internet, making web-based applications the most accessible and convenient method to disseminate information. Print-based media like newspapers may not have the same reach and engagement among young adults. Television advertisements might reach a broader audience, but they may not be as targeted to the specific demographic of young adults. Brochures in kiosks in malls are less likely to reach a large number of young adults compared to web-based applications, which can be accessed anytime and anywhere through mobile devices.

4. A nurse is planning care for a client who has a chest tube. Which of the following actions should the nurse take to ensure proper functioning of the chest tube?

• A. Clamp the chest tube intermittently.
• B. Keep the drainage system below chest level.
• C. Empty the drainage chamber every 4 hours.
• D. Apply sterile gauze around the insertion site daily.

Correct answer: B

Rationale: To ensure proper functioning of a chest tube, the nurse should keep the drainage system below chest level. This position allows for proper drainage by gravity and prevents backflow into the pleural space. Clamping the chest tube intermittently can lead to a buildup of pressure and should be avoided. Emptying the drainage chamber every 4 hours is important but not directly related to maintaining the chest tube's function. Applying sterile gauze around the insertion site daily is essential for infection prevention but does not specifically ensure the proper functioning of the chest tube.

5. A nurse is assessing a client who has pericarditis. Which of the following findings is the priority?

• A. Paradoxical pulse
• B. Dependent edema
• C. Pericardial friction rub
• D. Substernal chest pain

Correct answer: A

Rationale: The correct answer is A: Paradoxical pulse. Paradoxical pulse, which is a significant drop in systolic blood pressure during inspiration, indicates cardiac tamponade, a life-threatening complication of pericarditis. This finding requires immediate attention as it suggests potential compromised cardiac function. Choices B, C, and D are associated with pericarditis but do not indicate the same level of urgency as paradoxical pulse.

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