Nursing Elites

1. A nurse is planning care for a client who has chronic obstructive pulmonary disease (COPD). Which of the following actions should the nurse take?

• A. Encourage the client to increase physical activity.
• B. Place the client in the Trendelenburg position.
• C. Limit the client's fluid intake to prevent fluid overload.
• D. Administer high-flow oxygen via mask.

Correct answer: A

Rationale: The correct action for the nurse to take when caring for a client with COPD is to encourage the client to increase physical activity. Increased physical activity helps manage COPD symptoms by improving lung function and preventing deconditioning. Placing the client in the Trendelenburg position is not recommended for COPD as it can worsen breathing difficulties. Limiting fluid intake to prevent fluid overload is not typically necessary in COPD unless the client has comorbid conditions that require fluid restriction. Administering high-flow oxygen via mask may be necessary for COPD clients with severe hypoxemia, but it is not the initial action for planning care.

2. A nurse is reviewing the results of an arterial blood gas analysis of a client who has chronic obstructive pulmonary disease. Which of the following results should the nurse expect?

• A. PaO2 of 95 mm Hg
• B. PaCO2 of 55 mm Hg
• C. HCO3 of 24 mEq/L
• D. pH level of 7.35

Correct answer: B

Rationale: In chronic obstructive pulmonary disease, there is impaired gas exchange, leading to retention of carbon dioxide (CO2) and subsequent respiratory acidosis. A PaCO2 of 55 mm Hg is higher than the normal range (35-45 mm Hg) and is indicative of respiratory acidosis in COPD. Choices A, C, and D are not typically associated with COPD. PaO2 may be decreased, HCO3 may be elevated to compensate for acidosis, and pH may be lower than 7.35 due to respiratory acidosis in COPD.

3. A nurse is discussing group treatment and therapy with a client. The nurse should include which of the following as being a characteristic of a therapeutic group?

• A. The group is organized in an autocratic structure
• B. The group encourages members to focus on a particular issue
• C. The group must be led by a licensed psychiatrist
• D. The group encourages clients to form dependent relationships

Correct answer: B

Rationale: The correct answer is B. Therapeutic groups indeed encourage members to focus on particular issues. This focus helps individuals address specific concerns, work through challenges, and support one another in a structured setting. Choice A is incorrect because therapeutic groups typically promote a democratic structure that values input from all members rather than an autocratic one. Choice C is incorrect as therapeutic groups can be led by various mental health professionals, not solely by licensed psychiatrists. Choice D is incorrect; therapeutic groups aim to foster independent growth and self-reliance rather than promoting dependent relationships.

4. A nurse is planning care for a client with thrombocytopenia. Which action should the nurse include in the care plan?

• A. Encourage the client to floss daily.
• B. Remove fresh flowers from the client's room.
• C. Provide the client with a stool softener.
• D. Avoid serving raw vegetables.

Correct answer: C

Rationale: The correct action the nurse should include in the care plan for a client with thrombocytopenia is to provide the client with a stool softener. Thrombocytopenia is a condition characterized by a low platelet count, which can lead to increased bleeding tendencies. Providing a stool softener helps prevent constipation and straining during bowel movements, reducing the risk of bleeding. Encouraging the client to floss daily (Choice A) is important for oral hygiene but is not directly related to managing thrombocytopenia. Removing fresh flowers from the client's room (Choice B) is more related to preventing infections in immunocompromised clients. Avoiding serving raw vegetables (Choice D) is important for clients with compromised immune systems but is not specifically targeted at managing thrombocytopenia.

5. A nurse is reviewing admission prescriptions for a group of clients. Which prescription should the nurse identify as complete?

• A. Furosemide 20 mg BID
• B. Aspirin 1 tablet daily
• C. Nitroglycerin transdermal patch
• D. Metoprolol 5 mg IV now

Correct answer: A

Rationale: The correct answer is A. A complete prescription should include the medication name (Furosemide), dosage (20 mg), and administration schedule (BID - twice daily). Choice B is missing the dosage of Aspirin, choice C lacks the dosage information for Nitroglycerin, and choice D does not specify the administration schedule for Metoprolol.

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