Nursing Elites

1. A patient with chronic obstructive pulmonary disease (COPD) is prescribed tiotropium. What is the primary purpose of this medication?

• A. Reduce mucus production
• B. Relieve bronchospasm
• C. Suppress cough
• D. Thin respiratory secretions

Correct answer: B

Rationale: Tiotropium is a long-acting bronchodilator used to relieve bronchospasm and improve airflow in patients with chronic obstructive pulmonary disease (COPD). It works by relaxing the muscles around the airways, leading to bronchodilation and improved breathing, making it an essential treatment in managing COPD symptoms.

2. An elderly client with congestive heart failure (CHF) is admitted to the hospital. Which laboratory test result should the nurse expect to find?

• A. Elevated serum sodium level.
• B. Decreased brain natriuretic peptide (BNP) level.
• C. Increased serum creatinine level.
• D. Elevated hemoglobin and hematocrit levels.

Correct answer: C

Rationale: In clients with congestive heart failure (CHF), impaired cardiac function can lead to decreased renal perfusion, resulting in elevated serum creatinine levels. Therefore, an increased serum creatinine level is a common laboratory finding in CHF clients, indicating possible renal impairment.

3. A primipara at 38-weeks gestation is admitted to labor and delivery for a biophysical profile (BPP). The nurse should prepare the client for what procedures?

• A. Chorionic villus sampling under ultrasound.
• B. Amniocentesis and fetal monitoring.
• C. Ultrasonography and nonstress test.
• D. Oxytocin challenge test and fetal heart rate monitoring.

Correct answer: C

Rationale: A biophysical profile (BPP) is a prenatal test that assesses the well-being of the fetus. It typically includes ultrasonography to evaluate fetal movements, muscle tone, breathing movements, and amniotic fluid volume. Additionally, a nonstress test is performed to monitor the fetal heart rate in response to its movements. These tests help in determining the overall health and viability of the fetus, making them essential components of prenatal care for assessing fetal well-being.

4. A client has been diagnosed with an esophageal diverticulum after undergoing diagnostic imaging. When taking the health history, the nurse should expect the client to describe what sign or symptom?

• A. Burning pain on swallowing
• B. Regurgitation of undigested food
• C. Symptoms mimicking a myocardial infarction
• D. Chronic parotid abscesses

Correct answer: B

Rationale: Regurgitation of undigested food is a typical symptom of esophageal diverticulum. This condition forms a pouch in the esophagus that can trap food, leading to regurgitation of undigested food. The other options are not typically associated with esophageal diverticulum.

5. What is the primary goal of care for a client experiencing esophageal varices secondary to liver cirrhosis?

• A. Preventing infection
• B. Controlling bleeding
• C. Reducing portal hypertension
• D. Maintaining nutritional status

Correct answer: B

Rationale: The primary goal of care for a client with esophageal varices secondary to liver cirrhosis is to control bleeding. Esophageal varices are fragile, enlarged veins in the esophagus that can rupture and lead to life-threatening bleeding. Controlling bleeding is crucial to prevent severe complications and ensure the client's safety and well-being. Preventing infection (Choice A) is important but not the primary goal in this case. Reducing portal hypertension (Choice C) is a long-term goal that may help prevent variceal bleeding but is not the immediate priority. Maintaining nutritional status (Choice D) is essential for overall health but is secondary to controlling bleeding in this critical situation.

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