Nursing Elites

1. For a patient with asthma, what is the primary purpose of prescribing salmeterol?

• A. Relieve acute bronchospasm
• B. Prevent asthma attacks
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Salmeterol is classified as a long-acting beta2-agonist, which is used to prevent asthma attacks by providing extended bronchodilation. It is not typically used for immediate relief of acute bronchospasm or for suppressing cough. Additionally, salmeterol does not have the primary purpose of thinning respiratory secretions.

2. After a client's neck dissection surgery resulted in damage to the superior laryngeal nerve, what area of assessment should the nurse prioritize?

• A. The client's swallowing ability
• B. The client's ability to speak
• C. The client's management of secretions
• D. The client's airway patency

Correct answer: A

Rationale: Damage to the superior laryngeal nerve can lead to swallowing difficulties due to impaired laryngeal function. As a result, assessing the client's swallowing ability is crucial to prevent aspiration and ensure proper nutrition and hydration.

3. Which assessment finding indicates a client's readiness to leave the nursing unit for a bronchoscopy?

• A. Client denies allergies to contrast media.
• B. Skin prep to insertion site completed.
• C. On-call sedation administered.
• D. Oxygen at 2 L/minute via nasal cannula.

Correct answer: C

Rationale: Administering on-call sedation is crucial before a bronchoscopy to ensure the client is comfortable and adequately prepared for the procedure. Sedation helps reduce anxiety, discomfort, and ensures the client remains still during the bronchoscopy, enabling the healthcare provider to perform the procedure effectively.

4. A 56-year-old woman with rheumatoid arthritis has severe joint pain and swelling in her hands. She has a history of peptic ulcer disease five years ago but presently has no GI symptoms. You elect to start her on an NSAID. Which of the following is correct?

• A. Proton-pump inhibitors and H2-blockers are equally effective in prophylaxis against NSAID-related GI toxicity.
• B. Misoprostol is superior to an H2-blocker in prophylaxis against NSAID-related GI toxicity.
• C. Sucralfate is not the drug of choice for prophylaxis in this patient.
• D. H. pylori infection can alter the risk for an NSAID-induced ulcer.

Correct answer: B

Rationale: In this scenario, the patient's history of peptic ulcer disease puts her at risk for NSAID-related GI toxicity. Misoprostol and proton-pump inhibitors have shown superiority over H2-blockers in preventing NSAID-related GI toxicity. H. pylori infection can indeed increase the risk of an NSAID-induced ulcer in infected patients who are starting NSAID therapy. Sucralfate has not been proven to be effective in prophylaxis against NSAID-related GI toxicity. Therefore, the correct choice is B, as misoprostol is the preferred option over an H2-blocker in this context.

5. When covering another nurse's assignment during a lunch break, based on the status report provided, which client should the charge nurse check first?

• A. The client admitted yesterday with diabetic ketoacidosis whose blood glucose level is now 195 mg/dl.
• B. The client with an ileal conduit created two days ago with a scant amount of blood in the drainage pouch.
• C. The client post-triple coronary bypass four days ago who has serosanguinous drainage in the chest tube.
• D. The client with a pneumothorax secondary to a gunshot wound with a current pulse oximeter reading of 90%.

Correct answer: D

Rationale: The client with a pneumothorax and a pulse oximeter reading of 90% indicates potential respiratory compromise, requiring immediate attention to prevent further deterioration.

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