Nursing Elites

1. A client with chronic obstructive pulmonary disease (COPD) is being taught by a healthcare provider. Which statement by the client indicates a need for further teaching?

• A. I will avoid smoking to prevent further damage to my lungs.
• B. I will eat smaller, more frequent meals to avoid feeling bloated.
• C. I will exercise every day to improve my strength and endurance.
• D. I will drink plenty of fluids to help thin my mucus.

Correct answer: C

Rationale: The correct answer is C. While exercise is important for clients with COPD, daily exercise may be too strenuous. Clients should be encouraged to exercise regularly but should be advised to avoid overexertion. Statements A, B, and D demonstrate appropriate understanding and management of COPD symptoms.

2. A healthcare provider is preparing to admit a client to the PACU who received a competitive neuromuscular blocking agent. Which of the following items should the provider place at the client's bedside?

• A. Bag valve mask device
• B. Defibrillator machine
• C. Chest tube equipment
• D. Central venous catheter tray

Correct answer: A

Rationale: When a client receives a competitive neuromuscular blocking agent, it can lead to respiratory muscle paralysis. Placing a bag valve mask device at the client's bedside is crucial for providing immediate respiratory support in case of respiratory depression or failure. This device allows manual ventilation by squeezing the bag to deliver breaths to the client. The other options, such as a defibrillator machine, chest tube equipment, and central venous catheter tray, are not directly related to managing respiratory complications associated with neuromuscular blockade.

3. A client has burns to his face, ears, and eyelids. What is the priority finding for the nurse to report to the provider?

• A. Urinary output of 25 mL/hr
• B. Difficulty swallowing
• C. Heart rate of 122/min
• D. Pain level of 6 on a scale of 0 to 10

Correct answer: B

Rationale: When a client has burns involving the face, ears, and eyelids, the priority finding to report to the provider is difficulty swallowing. This symptom could indicate potential airway compromise or swelling in the throat, which can lead to serious complications. Monitoring and addressing this issue promptly is crucial to ensure the client's airway remains patent and secure.

4. During an admission assessment of a client with COPD and emphysema complaining of a frequent productive cough and shortness of breath, what assessment finding should the nurse anticipate?

• A. Respiratory alkalosis
• B. Increased anteroposterior diameter of the chest
• C. Oxygen saturation level 96%
• D. Petechiae on chest

Correct answer: B

Rationale: COPD and emphysema are chronic respiratory conditions that can lead to changes in the shape of the chest. In clients with COPD, the anteroposterior diameter of the chest often increases, giving a barrel chest appearance. This change in chest shape is due to hyperinflation of the lungs and is a common physical finding in clients with COPD and emphysema. The other options are not typically associated with COPD and emphysema. Respiratory alkalosis is not a common finding in these clients. An oxygen saturation level of 96% is within the normal range and does not specifically relate to COPD. Petechiae on the chest are not typically associated with COPD or emphysema.

5. The healthcare provider is caring for a client who has heart failure and a history of asthma. The provider reviews the orders and recognizes that clarification is needed for which of the following medications?

• A. Carvedilol
• B. Fluticasone
• C. Captopril
• D. Isosorbide dinitrate

Correct answer: B

Rationale: The correct answer is Fluticasone. Carvedilol, Captopril, and Isosorbide dinitrate are commonly used in heart failure management and do not typically pose significant risks for clients with a history of asthma. However, Fluticasone is a corticosteroid used to manage asthma but can potentially worsen heart failure symptoms due to its anti-inflammatory effects. Therefore, the nurse should seek clarification regarding the prescription of Fluticasone for a client with heart failure and a history of asthma.

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