Nursing Elites

1. How should a healthcare professional care for a client approaching death with shortness of breath and noisy respirations?

• A. Turn the client every 2 hours
• B. Provide supplemental oxygen
• C. Use a fan to reduce the feeling of breathlessness
• D. Administer diuretics as prescribed

Correct answer: C

Rationale: In a palliative care setting, when caring for a client approaching death with symptoms of shortness of breath and noisy respirations, using a fan can help alleviate the sensation of breathlessness. This intervention can provide comfort by improving air circulation and reducing the perception of breathlessness. Turning the client every 2 hours may not directly address the respiratory distress caused by noisy respirations. Providing supplemental oxygen may not be indicated or effective in all cases, especially in end-of-life care where the focus is on comfort rather than aggressive interventions. Administering diuretics as prescribed would not be appropriate for addressing noisy respirations and shortness of breath in a dying client, as this may not be related to fluid overload or congestion. Therefore, the most appropriate action to help the client feel more comfortable in this situation is to use a fan to reduce the feeling of breathlessness.

2. During the stages of dying, a client reaches the point of acceptance. What response should the LPN/LVN expect the client to exhibit?

• A. Apathy
• B. Euphoria
• C. Detachment
• D. Emotionalism

Correct answer: C

Rationale: During the stages of dying, when a client reaches the point of acceptance, the expected response is 'Detachment.' This is characterized by the individual withdrawing emotionally and psychologically from their surroundings as they come to terms with their impending death. Apathy (Choice A) refers to a lack of interest, enthusiasm, or concern, which is not typically associated with the acceptance stage. Euphoria (Choice B) is an intense feeling of happiness or excitement, which is less likely during the acceptance stage of dying. Emotionalism (Choice D) involves exaggerated or uncontrollable emotional reactions, which are not commonly seen during the acceptance phase.

3. What are the correct steps used for abdominal assessment?

• A. Inspection, auscultation, percussion, palpation
• B. Palpation, inspection, auscultation, percussion
• C. Percussion, palpation, inspection, auscultation
• D. Auscultation, palpation, percussion, inspection

Correct answer: A

Rationale: The correct order for abdominal assessment is inspection, auscultation, percussion, and palpation. Inspection allows the nurse to visually assess the abdomen for any abnormalities or distension. Auscultation follows to listen for bowel sounds and vascular sounds. Percussion helps to assess the density of underlying structures and detect any abnormal masses. Palpation is performed last to assess tenderness, organ size, and detect any masses. Choices B, C, and D have the steps in the incorrect order, making them the wrong choices.

4. A patient has damage to the cerebellum. Which disorder is most important for the nurse to assess?

• A. Impaired balance
• B. Hemiplegia
• C. Muscle sprain
• D. Lower extremity paralysis

Correct answer: A

Rationale: When the cerebellum is damaged, it leads to impaired balance. The cerebellum plays a crucial role in coordinating movements and maintaining balance. Therefore, assessing the patient's balance is essential in determining the extent of cerebellar damage. Options B, C, and D are incorrect because hemiplegia refers to paralysis of one side of the body, muscle sprain is a soft tissue injury, and lower extremity paralysis involves loss of function in the lower limbs. These conditions are not directly associated with damage to the cerebellum.

5. A healthcare professional is preparing to administer an opioid medication to a client for pain management. Which of the following actions should the healthcare professional take?

• A. Administer the medication as prescribed without any additional monitoring.
• B. Monitor the client for respiratory depression.
• C. Administer the medication only when the client requests it.
• D. Ask another healthcare professional to verify the medication before administration.

Correct answer: B

Rationale: When administering opioid medications, it is crucial to monitor the client for respiratory depression, which is a potential side effect of opioids. Monitoring for respiratory depression is a critical safety measure to ensure the client's well-being during opioid therapy. Option A is incorrect because additional monitoring, especially for respiratory depression, is necessary when giving opioids to prevent adverse effects. Option C is incorrect as administering the medication only upon client request may compromise effective pain management and adherence to the prescribed regimen. Option D is incorrect as medication verification by another healthcare professional is essential for safety but not directly related to monitoring the client for respiratory depression after opioid administration.

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