Nursing Elites

1. A nurse is teaching a client with mild persistent asthma about montelukast. Which statement by the client indicates understanding?

• A. I will use this for asthma attacks.
• B. I should take this before exercise.
• C. This medication will decrease swelling and mucus production.
• D. I can stop this medication after 10 days.

Correct answer: C

Rationale: Montelukast is a leukotriene receptor antagonist that helps reduce swelling and mucus production in the airways, making it useful for long-term asthma management.

2. A nurse is caring for an infant who has a prescription for continuous pulse oximetry. Which of the following is an appropriate action for the nurse to take?

• A. Place the infant under a radiant warmer
• B. Move the probe site every 3 hours
• C. Heat the skin one minute prior to placing the probe
• D. Place the sensor on the index finger

Correct answer: B

Rationale: The correct answer is to move the probe site every 3 hours. This action helps prevent skin breakdown and ensures more accurate monitoring of oxygen saturation. Placing the infant under a radiant warmer (choice A) is unnecessary and not related to pulse oximetry. Heating the skin before placing the probe (choice C) can lead to burns and is not recommended. Placing the sensor on the index finger (choice D) is not appropriate for continuous monitoring in infants.

3. A client is preparing advance directives. Which of the following statements by the client indicates an understanding of advance directives?

• A. I cannot change my instructions once they are made
• B. My doctor will need to approve my advance directives
• C. I need an attorney to witness my signature on the advance directives
• D. I have the right to refuse treatment

Correct answer: D

Rationale: The correct answer is D: 'I have the right to refuse treatment.' This statement indicates an understanding of advance directives because advance directives allow individuals to express their treatment preferences, including the right to refuse treatment if they choose to do so. Choice A is incorrect because individuals can update or change their advance directives as needed. Choice B is incorrect because advance directives are based on the individual's preferences, not the doctor's approval. Choice C is incorrect as witnessing an advance directive typically requires a witness who is not an attorney, depending on the state's specific requirements.

4. What can cause a low pulse oximetry reading?

• A. Hyperthermia
• B. Increased hemoglobin level
• C. Inadequate peripheral circulation
• D. Low altitudes

Correct answer: C

Rationale: Inadequate peripheral circulation can cause a low pulse oximetry reading by limiting blood flow to the area being measured, leading to inaccurate oxygen saturation readings. Hyperthermia (choice A) is an elevated body temperature and does not directly affect pulse oximetry readings. An increased hemoglobin level (choice B) would actually lead to higher oxygen-carrying capacity in the blood, resulting in normal or increased pulse oximetry readings. Low altitudes (choice D) typically do not cause low pulse oximetry readings unless there are other underlying conditions affecting oxygen levels.

5. When resolving a conflict, which statement made by the charge nurse is an example of smoothing?

• A. You have been a nurse a long time, so I’m sure you’re capable of the tasks.
• B. If you prefer, I can take over your assignment.
• C. We can switch your assignment with someone else.
• D. Let’s discuss your concerns in a private setting.

Correct answer: A

Rationale: The correct answer is A because it exemplifies smoothing, a conflict resolution strategy where the charge nurse reassures the staff nurse of their capabilities. Choice B offers to take over the assignment, which is more of a compromising strategy. Choice C suggests switching assignments, which aligns with compromising rather than smoothing. Choice D proposes a discussion in a private setting, indicating a collaborating approach rather than smoothing.

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