Nursing Elites

1. The nurse is assessing a client with chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse expect?

• A. Decreased anteroposterior diameter
• B. Hyperresonance on percussion
• C. Increased breath sounds
• D. Prolonged expiratory phase

Correct answer: D

Rationale: The correct answer is D: Prolonged expiratory phase. In COPD, there is airflow obstruction leading to difficulty in exhaling air. This results in a prolonged expiratory phase. Choices A, B, and C are incorrect. Decreased anteroposterior diameter is associated with conditions like barrel chest in emphysema, not COPD. Hyperresonance on percussion is typical in conditions like emphysema, not necessarily in COPD. Increased breath sounds are not a typical finding in COPD; instead, diminished breath sounds may be present due to air trapping.

2. The nurse is planning care for a client with increased intracranial pressure. The best position for this client is

• A. Trendelenburg
• B. Prone
• C. Semi-Fowler's
• D. Side-lying with head flat

Correct answer: C

Rationale: The correct answer is C, Semi-Fowler's. This position helps to reduce intracranial pressure by promoting venous drainage from the head while maintaining adequate oxygenation. Option A, Trendelenburg position, is incorrect as it involves placing the patient with the head lower than the body, which can increase intracranial pressure. Option B, Prone position, is also incorrect as it involves lying on the stomach, which can further elevate intracranial pressure. Option D, Side-lying with head flat, does not provide the same benefits as the Semi-Fowler's position in terms of promoting venous drainage and maintaining oxygenation in a client with increased intracranial pressure.

3. Which family planning method is not advisable for women with extremely irregular menstrual periods?

• A. oral contraceptives
• B. diaphragm
• C. natural family planning
• D. vaginal contraceptives

Correct answer: C

Rationale: Natural family planning relies on tracking menstrual cycles to determine fertile days for avoiding or achieving pregnancy. It may not be suitable for women with extremely irregular menstrual periods as it can be challenging to predict fertile days accurately. Oral contraceptives (A), diaphragms (B), and vaginal contraceptives (D) do not rely on regular menstrual cycles for their effectiveness, making them more suitable options for women with irregular periods.

4. The nurse is teaching a group of adults about modifiable cardiac risk factors. Which of the following should the nurse focus on first?

• A. Weight reduction
• B. Stress management
• C. Physical exercise
• D. Smoking cessation

Correct answer: D

Rationale: The correct answer is D, smoking cessation. Smoking is a major and modifiable risk factor for cardiovascular disease. It is often the highest priority in cardiac risk reduction because stopping smoking has immediate and long-term benefits for heart health. Choices A, B, and C are also important in reducing cardiac risk factors, but smoking cessation takes precedence due to its significant impact on cardiovascular health.

5. The Healthy People project is designed to:

• A. track health care trends to anticipate insurance liabilities, especially for poor and urban populations
• B. demonstrate that social factors have a significant impact on individual and community health
• C. follow health indicators such as activity, substance use, mental health, and environmental issues
• D. demonstrate that access to health care in the United States is adequate for all populations

Correct answer: C

Rationale: The Healthy People project is designed to follow health indicators such as activity, substance use, mental health, and environmental issues to improve public health outcomes. Choice A is incorrect because the project focuses on public health indicators rather than insurance liabilities. Choice B is incorrect as the project actually acknowledges the significant impact of social factors on health. Choice D is incorrect because one of the main goals of the Healthy People project is to identify and address disparities in access to healthcare, not to demonstrate that access is adequate for all populations.

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