Nursing Elites

1. A nurse is teaching a client who has peripheral arterial disease (PAD) about exercise recommendations. Which of the following instructions should the nurse include?

• A. Exercise to the point of pain
• B. Stop exercising if pain occurs
• C. Exercise only once per week
• D. Avoid walking to prevent pain

Correct answer: B

Rationale: The correct instruction the nurse should include is to 'Stop exercising if pain occurs.' In peripheral arterial disease (PAD), it is crucial to avoid exercising to the point of pain as this may worsen the condition and lead to complications. Exercising to the point of pain can result in inadequate blood flow to the extremities, causing further damage. By stopping exercise if pain occurs, the client can prevent exacerbating their condition. Choices A, C, and D are incorrect because exercising to the point of pain, limiting exercise to once per week, and avoiding walking altogether are not recommended strategies for managing PAD and could potentially harm the client.

2. What are the nursing interventions for a patient with neutropenia?

• A. Monitor for signs of infection and administer antibiotics
• B. Isolate the patient and provide a low-microbial diet
• C. Monitor vital signs and avoid unnecessary invasive procedures
• D. Encourage the patient to engage in social activities

Correct answer: A

Rationale: The correct nursing interventions for a patient with neutropenia include monitoring for signs of infection and administering antibiotics. Neutropenia is characterized by a low neutrophil count, which increases the risk of infections. Monitoring for signs of infection allows for early detection and prompt treatment, while administering antibiotics helps prevent or treat any infections that may occur. Isolating the patient and providing a low-microbial diet (Choice B) are not necessary unless the patient develops an active infection. Monitoring vital signs and avoiding unnecessary invasive procedures (Choice C) are important but do not specifically address the increased infection risk in neutropenic patients. Encouraging the patient to engage in social activities (Choice D) is not appropriate for a neutropenic patient due to the risk of exposure to infectious agents.

3. A nurse is caring for a client who is postoperative following abdominal surgery. Which of the following actions should the nurse take to prevent atelectasis?

• A. Encourage deep breathing exercises
• B. Encourage the client to cough every 2 hours
• C. Administer an incentive spirometer
• D. Assist the client to ambulate in the hallway

Correct answer: C

Rationale: The correct answer is C: Administer an incentive spirometer. Using an incentive spirometer helps prevent atelectasis by encouraging lung expansion after surgery. Encouraging deep breathing exercises (choice A) is beneficial but may not be as effective as an incentive spirometer. Encouraging the client to cough (choice B) helps with airway clearance but does not directly prevent atelectasis. Assisting the client to ambulate (choice D) is important for preventing complications such as deep vein thrombosis, but it is not the most effective intervention for preventing atelectasis.

4. What should a healthcare professional do when a client with anorexia nervosa insists on working out constantly?

• A. Allow the client to workout and continue their regimen
• B. Restrict the client's workout regimen to one hour a day
• C. Discuss the risks of over-exercising with the client
• D. Speak to the client privately to uncover the source of the obsession

Correct answer: D

Rationale: When dealing with a client with anorexia nervosa who insists on working out constantly, it is crucial to address the situation sensitively. Speaking to the client privately to uncover the source of the obsession is the most appropriate action. This approach allows the healthcare professional to understand the underlying reasons for the behavior and work towards a solution together. Choices A and B could potentially exacerbate the client's condition by either enabling the behavior or imposing restrictions without addressing the root cause. While choice C is important, simply discussing the risks may not address the client's compulsion to exercise excessively.

5. How should a healthcare professional assess a patient with a tracheostomy?

• A. Monitor for infection and ensure airway patency
• B. Suction airway secretions and provide humidified oxygen
• C. Clean the stoma and change tracheostomy ties
• D. Educate the patient on tracheostomy care

Correct answer: A

Rationale: Corrected Question: To assess a patient with a tracheostomy, the healthcare professional should primarily focus on monitoring for infection and ensuring the airway remains patent. Choice A is the correct answer as these actions are crucial for tracheostomy management. Suctioning airway secretions and providing humidified oxygen (Choice B) are interventions that may be necessary based on the assessment findings but are not the initial assessment steps. Similarly, cleaning the stoma and changing tracheostomy ties (Choice C) are important aspects of tracheostomy care but do not specifically address the initial assessment. Educating the patient on tracheostomy care (Choice D) is important, but it is not the primary assessment action needed when assessing a patient with a tracheostomy.

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