Nursing Elites

1. A healthcare professional is monitoring a group of clients for increased risk of developing pneumonia. Which of the following clients should the healthcare professional NOT expect to be at risk?

• A. Client who has dysphagia
• B. Client who has AIDS
• C. Client who was vaccinated for pneumococcus and influenza 6 months ago
• D. Client who has a closed head injury and is receiving ventilation

Correct answer: C

Rationale: A client who was vaccinated for pneumococcus and influenza 6 months ago would have a reduced risk of developing pneumonia compared to those who have not been vaccinated. Vaccination helps protect individuals from specific pathogens, thereby lowering the risk of infection. Clients with dysphagia, AIDS, or a closed head injury and receiving ventilation are at higher risk for pneumonia due to compromised immunity, respiratory function, or protective airway reflexes, respectively.

2. Why is a precise amount of oxygen necessary for a patient with COPD to prevent which complication?

• A. Cardiac arrest related to increased partial pressure of carbon dioxide in arterial blood (PaCO2)
• B. Circulatory overload due to hypervolemia
• C. Respiratory excitement
• D. Inhibition of the respiratory hypoxic stimulus

Correct answer: D

Rationale: In patients with COPD, the respiratory drive is often stimulated by low oxygen levels. Administering too much oxygen can inhibit this hypoxic drive, leading to respiratory depression and potential respiratory failure. Therefore, it is crucial to carefully regulate the oxygen therapy to prevent the inhibition of the respiratory hypoxic stimulus in COPD patients.

3. Palpating the midclavicular line is the correct technique for assessing

• A. Baseline vital signs
• B. Systolic blood pressure
• C. Respiratory rate
• D. Apical pulse

Correct answer: D

Rationale: Palpating the midclavicular line is the correct technique for assessing the apical pulse. The apical pulse is located at the point of maximal impulse (PMI), which is typically at the fifth intercostal space at the midclavicular line. This technique allows healthcare providers to accurately assess the heart rate and rhythm by listening to the heart sounds directly at this point.

4. After 5 days of diuretic therapy with 20mg of furosemide (Lasix) daily, a patient begins to exhibit fatigue, muscle cramping, and muscle weakness. These symptoms probably indicate that the patient is experiencing:

• A. Hypokalemia
• B. Hyperkalemia
• C. Anorexia
• D. Dysphagia

Correct answer: A

Rationale: The symptoms of fatigue, muscle cramping, and muscle weakness in a patient after starting furosemide therapy are indicative of hypokalemia. Furosemide is a loop diuretic that can lead to potassium depletion, causing hypokalemia. Hypokalemia can manifest with muscle weakness, cramps, and fatigue due to alterations in neuromuscular function and decreased ATP production.

5. A client with active tuberculosis is prescribed isoniazid, rifampin, pyrazinamide, and ethambutol. Which statement by the client indicates an understanding of the teaching?

• A. I can substitute one medication for another if I run out because they all fight infection.
• B. I will wash my hands each time I cough.
• C. I am glad I don't have to have any more sputum specimens.
• D. I don't need to worry about where I go once I start taking my medications.

Correct answer: B

Rationale: The correct statement indicating understanding of tuberculosis medication regimen is 'I will wash my hands each time I cough.' This statement shows knowledge of infection control practices to prevent the spread of tuberculosis. Washing hands after coughing helps in reducing the transmission of the disease to others. The other options are incorrect. Option A is incorrect as each medication in the regimen has a specific role, and substituting one for another can compromise the effectiveness of treatment. Option C is incorrect as obtaining sputum specimens is essential for monitoring treatment response. Option D is incorrect as the client should still adhere to infection control measures and avoid exposing others to tuberculosis.

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