Nursing Elites

1. A client with chronic obstructive pulmonary disease is receiving dietary teaching from a nurse. Which of the following instructions should the nurse include?

• A. Eat 3 balanced meals each day.
• B. Limit fluid intake with meals.
• C. Reduce sodium intake.
• D. Take a bronchodilator 1 hour before eating.

Correct answer: B

Rationale: In clients with chronic obstructive pulmonary disease, limiting fluid intake with meals can help reduce the risk of bloating and feeling too full, which can make breathing more difficult due to increased pressure on the diaphragm. It is important to encourage a balanced diet with appropriate fluid intake between meals to maintain hydration and proper nutrition. Options A, C, and D are not specifically related to dietary recommendations for clients with chronic obstructive pulmonary disease.

2. A newly graduated nurse in the hospital states that, since she is so new, she cannot participate in quality improvement (QI) projects. What response by the precepting nurse is best?

• A. All staff nurses are required to participate in quality improvement projects.
• B. Even as a new nurse, you can implement activities designed to improve care.
• C. It's easy to identify which indicators should be used to measure quality improvement.
• D. You should ask to be assigned to the research and quality committee.

Correct answer: B

Rationale: The best response is to encourage the newly graduated nurse to actively participate in quality improvement initiatives. Being new does not preclude one from contributing to improving care processes and outcomes. By engaging in small activities focused on quality improvement, the new nurse can start making a positive impact and learn valuable skills early in their career.

3. A client is interested in smoking cessation. Which statements should the nurse include in this client's teaching? (Select ONE that does not apply)

• A. Find an activity that you enjoy and will keep your hands busy.
• B. Make a list of reasons you want to stop smoking.
• C. Identify a punishment for yourself in case you backslide.
• D. Drink at least eight glasses of water each day.

Correct answer: D

Rationale: When educating a client on smoking cessation, the nurse should include several strategies. Finding an activity to keep hands busy helps distract from smoking urges. Making a list of reasons to quit smoking reinforces motivation. Identifying a consequence for backsliding can serve as a deterrent. Drinking water is beneficial for overall health but is not directly related to smoking cessation. It's crucial to support the client, encourage healthy habits, and address challenges without punitive measures.

4. A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding should the nurse expect?

• A. Increased anterior-posterior (AP) chest diameter
• B. Decreased respiratory rate
• C. Weight gain
• D. Productive cough with yellow sputum

Correct answer: A

Rationale: In chronic obstructive pulmonary disease (COPD), clients often develop a barrel chest, characterized by an increased anterior-posterior diameter of the chest due to hyperinflation of the lungs. This change in chest shape is a common finding in COPD. Decreased respiratory rate, weight gain, and productive cough with yellow sputum are not typical findings associated with COPD.

5. A nurse is assessing a client for a suspected anaphylactic reaction following a CT scan with contrast media. For which of the following client findings should the nurse intervene first?

• A. Urticaria
• B. Stridor
• C. Vomiting
• D. Hypotension

Correct answer: B

Rationale:

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