Nursing Elites

1. A patient asks the nurse whether he is a good candidate to use a CPAP machine. The nurse reviews the client's history. Which condition would contraindicate the use of a CPAP machine?

• A. The patient is in the late stage of dementia.
• B. The patient has a history of bronchitis.
• C. The patient has had suicidal gestures/attempts in the past.
• D. The patient is on beta-blockers.

Correct answer: A

Rationale: The correct answer is that the patient is in the late stage of dementia. In late-stage dementia, individuals may have an inability to follow commands and understand instructions independently, which are essential for proper installation and use of a CPAP machine. This makes using a CPAP machine challenging and potentially ineffective for patients in this condition. Choice B, having a history of bronchitis, does not contraindicate the use of a CPAP machine. In fact, CPAP therapy can be beneficial for patients with respiratory conditions like bronchitis. Choice C, a history of suicidal gestures/attempts, while concerning for the patient's mental health, does not directly contraindicate the use of a CPAP machine. Choice D, being on beta-blockers, is not a contraindication for CPAP machine use. Beta-blockers are commonly used medications for various conditions and do not interfere with the use of a CPAP machine.

2. After an endoscopic procedure with general anesthesia, what is a priority nursing consideration for a patient in the day surgery center?

• A. Raise the siderails of the patient's bed
• B. Do not offer fluids, food, or any oral intake
• C. Check the temperature of the patient
• D. Teach the patient to avoid aspirin or NSAIDS

Correct answer: B

Rationale: After an endoscopic procedure with general anesthesia, the priority nursing consideration is to not offer fluids, food, or any oral intake to the patient. Endoscopies involve passing a tube through the mouth into the esophagus or upper GI. Anesthesia is often given to inactivate the gag reflex, making the patient vulnerable to aspiration. Raising the siderails of the patient's bed is important for safety but not the immediate priority. Checking the patient's temperature may be important but is not the priority immediately after the procedure. Teaching the patient to avoid aspirin or NSAIDS is important for post-procedure care but is not the priority immediately after the endoscopic procedure.

3. A nurse caring for several patients in the cardiac unit is told that one is scheduled for implantation of an automatic internal cardioverter-defibrillator. Which of the following patients is most likely to have this procedure?

• A. A patient admitted for myocardial infarction without cardiac muscle damage.
• B. A postoperative coronary bypass patient, recovering on schedule.
• C. A patient with a history of ventricular tachycardia and syncopal episodes.
• D. A patient with a history of atrial tachycardia and fatigue.

Correct answer: C

Rationale: The correct answer is a patient with a history of ventricular tachycardia and syncopal episodes. An automatic internal cardioverter-defibrillator is used to deliver an electric shock to the heart to terminate episodes of ventricular tachycardia and ventricular fibrillation. These patients are at high risk of life-threatening arrhythmias, which may result in syncope. Patients with atrial tachycardia and fatigue (Choice D) would not typically require an implantable cardioverter-defibrillator as their primary issue is related to atrial arrhythmias. Patients who have had a myocardial infarction without cardiac muscle damage (Choice A) or postoperative coronary bypass patients recovering on schedule (Choice B) are not necessarily at high risk for ventricular arrhythmias and would not be the primary candidates for an implantable cardioverter-defibrillator.

4. The nurse completes discharge teaching for a patient who has had a lung transplant. The nurse evaluates that the teaching has been effective if the patient makes which statement?

• A. I will make an appointment to see the doctor every year.
• B. I will stop taking the prednisone if I experience a dry cough.
• C. I will not worry if I feel a little short of breath with exercise.
• D. I will call the health care provider right away if I develop a fever.

Correct answer: D

Rationale: The correct answer is, 'I will call the health care provider right away if I develop a fever.' It is crucial for patients who have undergone a lung transplant to be vigilant about any signs of infection or rejection. A low-grade fever can be an early indicator of such complications, requiring immediate medical attention. While annual follow-up visits are necessary, they are not sufficient for monitoring acute changes in health post-transplant. Stopping prednisone abruptly can lead to rejection and should only be done under healthcare provider guidance. Feeling short of breath with exercise should be reported as it can indicate potential issues. Recognizing and addressing symptoms promptly is key to successful post-transplant care, and in this case, calling the healthcare provider immediately for a fever is the most appropriate action.

5. Which of the following factors may alter the level of consciousness in a patient?

• A. Alcohol
• B. Electrolytes
• C. Infection
• D. All of the above may cause altered level of consciousness

Correct answer: D

Rationale: Various factors can lead to altered levels of consciousness in a patient. Alcohol consumption can depress the central nervous system and cause changes in consciousness. Electrolyte imbalances, such as hyponatremia or hypernatremia, can disrupt brain function and affect consciousness. Infections, especially those affecting the brain like encephalitis, can also lead to alterations in consciousness. Therefore, all of the choices provided - Alcohol, Electrolytes, and Infection - can potentially cause changes in the level of consciousness. Remember the acronym AEIOU-TIPPS to recall common causes of decreased level of consciousness, including Alcohol, Electrolytes, and Infection, among others.

Similar Questions