Nursing Elites

1. A patient with COPD is admitted with shortness of breath and a productive cough. Which of the following interventions should the nurse implement first?

• A. Administer oxygen at 4 L/min via nasal cannula
• B. Encourage the patient to cough and deep breathe
• C. Place the patient in a high-Fowler’s position
• D. Administer a bronchodilator as prescribed

Correct answer: C

Rationale: Placing the patient in a high-Fowler’s position should be implemented first. This intervention helps improve lung expansion, making it easier for the patient to breathe. Elevating the head of the bed reduces the work of breathing and can alleviate symptoms of respiratory distress. Administering oxygen, encouraging coughing and deep breathing, and administering a bronchodilator are important interventions in the care of a patient with COPD, but positioning the patient for optimal lung expansion takes precedence in this scenario.

2. A nurse on a medical unit is preparing to discharge a client to home. Which of the following actions should the nurse take as part of the medication reconciliation process?

• A. Discontinue current medications
• B. Write new prescriptions
• C. Compare prescriptions with the client’s medications
• D. Ask the client to decide

Correct answer: C

Rationale: The correct action in the medication reconciliation process is to compare prescriptions with the client’s medications. This step ensures that there are no conflicting medications prescribed, reducing the risk of adverse drug interactions. Discontinuing current medications or writing new prescriptions without comparing them can lead to errors and potential harm. Asking the client to decide is not appropriate in this context as it is the nurse's responsibility to ensure medication safety based on professional judgment and knowledge.

3. What is an appropriate parenting technique for time-out disciplining in children with mental health issues?

• A. Provide positive reinforcement for minor infractions
• B. Remove all privileges for at least one week following a violation
• C. Limit the child's time outside of the home environment
• D. Time-out should only be used in severe situations

Correct answer: B

Rationale: The correct answer is B: 'Remove all privileges for at least one week following a violation.' When dealing with children with mental health issues, it is essential to have consistent consequences for their actions. Providing positive reinforcement for minor infractions (choice A) may not effectively address inappropriate behaviors that require disciplinary action. Limiting the child's time outside the home environment (choice C) does not directly address the behavioral issue. Using time-out only in severe situations (choice D) may not provide consistent consequences for the child's behavior and can lead to escalation before interventions are used.

4. Which principle is most important for maintaining medical asepsis in a healthcare setting?

• A. Sterilize instruments only when visibly contaminated.
• B. Use sterile gloves for all patient interactions.
• C. Disinfect patient areas only at the end of the day.
• D. Clean hands thoroughly before and after patient contact.

Correct answer: D

Rationale: The correct answer is D: Clean hands thoroughly before and after patient contact. Hand hygiene is crucial for maintaining medical asepsis in a healthcare setting as it helps prevent the spread of infections between patients and healthcare workers. Choice A is incorrect because instruments should be sterilized regularly, not just when visibly contaminated. Choice B is incorrect as sterile gloves are not required for all patient interactions, only for specific procedures. Choice C is incorrect because patient areas should be disinfected regularly throughout the day, not just at the end of the day.

5. A hospice nurse is providing teaching to a client who has a new diagnosis of a terminal illness and her family. Which of the following statements should the nurse include in the teaching?

• A. Hospice care focuses on providing comfort and symptom management.
• B. The provider will coordinate your health care needs while in hospice.
• C. You do not need to choose a family caregiver before being admitted into a hospice facility.
• D. Hospice care continues to help families with grief after a death occurs.

Correct answer: D

Rationale: The correct answer is D because hospice care provides ongoing support to families with grief even after a patient's death. Choice A is incorrect because hospice care focuses on providing comfort and symptom management rather than disease treatment and rehabilitation. Choice B is incorrect as the statement does not accurately reflect the role of a hospice provider. Choice C is incorrect; a family caregiver is not a prerequisite for admission into a hospice facility.

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