Nursing Elites

1. A client is receiving discharge instructions from a healthcare provider after being prescribed albuterol for COPD. Which statement by the client indicates understanding of the teaching?

• A. Albuterol can increase my blood sugar levels.
• B. Albuterol can decrease my immune response.
• C. I can experience an increase in my heart rate while taking albuterol.
• D. I may develop mouth sores while taking albuterol.

Correct answer: C

Rationale: Albuterol is a bronchodilator commonly used to treat conditions like COPD. One of its common side effects is an increase in heart rate (tachycardia) due to its action on beta-2 receptors in the body. This statement by the client demonstrates an understanding of a potential side effect of albuterol, indicating comprehension of the discharge teaching provided by the healthcare provider.

2. Examples of patients suffering from impaired awareness include all of the following except:

• A. A semiconscious or overfatigued patient
• B. A disoriented or confused patient
• C. A patient who cannot care for themselves at home
• D. A patient demonstrating symptoms of drug or alcohol withdrawal

Correct answer: C

Rationale: Patients with impaired awareness may exhibit symptoms such as being semiconscious, overfatigued, disoriented, confused, or demonstrating symptoms of drug or alcohol withdrawal. A patient who cannot care for themselves at home does not necessarily indicate impaired awareness, as this could be due to physical limitations or lack of support, rather than a cognitive deficit.

3. Which of the following techniques involves the sense of sight?

• A. Inspection
• B. Palpation
• C. Percussion
• D. Auscultation

Correct answer: A

Rationale: The correct answer is Inspection (Choice A). Inspection is a technique that involves observing the patient using the sense of sight. During inspection, a healthcare provider visually examines the patient for any abnormalities, changes, or specific signs that may help in diagnosing a condition. Palpation (Choice B) involves using the sense of touch to feel for abnormalities. Percussion (Choice C) involves tapping the body to produce sounds that can help identify the underlying structures. Auscultation (Choice D) involves listening to sounds produced by the body, typically using a stethoscope. Therefore, in this context, the technique that specifically involves the sense of sight is Inspection.

4. A healthcare provider is caring for an adolescent who has sickle-cell anemia. Which of the following manifestations indicates acute chest syndrome and should be immediately reported to the provider?

• A. Substernal retractions
• B. Hematuria
• C. Temperature 37.9�C (100.2�F)
• D. Sneezing

Correct answer: A

Rationale: Substernal retractions are a concerning sign of respiratory distress and can indicate acute chest syndrome, a severe complication of sickle-cell anemia. It results from vaso-occlusion in the pulmonary vasculature, leading to impaired oxygenation. Prompt reporting of this symptom is crucial for early intervention to prevent further complications. Hematuria, a high temperature, and sneezing are not specific manifestations of acute chest syndrome and would not warrant immediate notification to the provider in this context.

5. A charge nurse is recommending postpartum client discharge following a local disaster. Which of the following should the nurse recommend for discharge?

• A. A 42-year-old client who has preeclampsia and a BP of 166/110 mm Hg
• B. A 15-year-old client who delivered via emergency cesarean birth 1 day ago
• C. A client who received 2 units of packed RBCs 6 hr ago for a postpartum hemorrhage
• D. A client who delivered precipitously 36 hr ago and has a second-degree perineal laceration

Correct answer: D

Rationale: The most appropriate client to recommend for discharge following a local disaster in the postpartum unit is the one who delivered precipitously 36 hours ago and has a second-degree perineal laceration. This client's condition is stable enough for discharge, and the timing and extent of the perineal laceration are within expectations for a safe discharge. Clients with conditions such as preeclampsia, recent emergency cesarean birth, or recent administration of packed RBCs for postpartum hemorrhage require further monitoring and care before being considered for discharge.

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