Nursing Elites

1. 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.

2. A client has returned from the surgical suite following surgery for a fractured mandible with intermaxillary fixation. Which of the following actions is the priority for the nurse to take?

• A. Prevent aspiration.
• B. Ensure adequate nutrition.
• C. Promote oral hygiene.
• D. Relieve the client's pain.

Correct answer: A

Rationale: Preventing aspiration is the priority for a client with intermaxillary fixation following mandibular surgery. Aspiration can occur due to difficulty swallowing or improper positioning, posing a serious risk to the client's respiratory status. It is crucial for the nurse to ensure that the client's airway is clear and that they are positioned correctly to prevent any potential aspiration events.

3. A client with chronic obstructive pulmonary disease is being taught by a nurse. Which nutritional information should the nurse include in the teaching? (SATA)

• A. Avoid drinking fluids just before and during meals.
• B. Rest before meals if you have dyspnea.
• C. Have about six small meals a day.
• D. Eat high-fiber foods to promote gastric emptying.

Correct answer: D

Rationale: In chronic obstructive pulmonary disease, it's important to consider the impact of nutrition on respiratory function. Eating high-fiber foods can lead to increased gas production, causing abdominal bloating and potentially worsening shortness of breath. Therefore, it is advisable for clients with COPD to avoid high-fiber foods to prevent these issues. Resting before meals can help manage dyspnea, and having smaller, more frequent meals can prevent bloating. Increasing calorie and protein intake is essential to prevent malnourishment in COPD patients. Additionally, limiting carbohydrate intake is crucial as it can increase carbon dioxide production, leading to a higher risk of acidosis in these individuals.

4. A healthcare professional is interested in making interdisciplinary work a high priority. Which actions by the professional best demonstrate this skill? (Select ONE that does not apply)

• A. Consulting with other disciplines on client care
• B. Coordinating discharge planning for home safety
• C. Participating in comprehensive client rounding
• D. Sharing the care plans with other disciplines

Correct answer: B

Rationale: Interdisciplinary work in healthcare involves effective communication and collaboration between different disciplines for holistic client care. Consulting with other disciplines allows for sharing expertise, insights, and perspectives to enhance client outcomes. Participating in comprehensive client rounding involves a team-based approach to discuss and plan client care collectively. Sharing nursing care plans with other disciplines ensures that all team members are informed and can contribute to the client's overall well-being. Coordinating discharge planning is important but may not directly demonstrate interdisciplinary collaboration as the other actions do.

5. 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.

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