Nursing Elites

1. The nurse is evaluating teaching about drug therapy to treat gout. Which statement by the client demonstrates an understanding of the use of allopurinol to treat Gout?

• A. I need to take the prescribed amount of the drug to get rid of my gout.
• B. I need to take this drug every day to keep from having any flare-ups.
• C. I should take this drug when I have gout attacks to reduce symptoms.
• D. The pain and swelling can be controlled by taking this drug every day.

Correct answer: B

Rationale: Taking allopurinol every day helps to prevent gout flare-ups by reducing uric acid levels.

2. A client admitted with left-sided heart failure has a heart rate of 110 beats per minute and is becoming increasingly dyspneic. Which additional assessment finding by the nurse supports the client’s admitting diagnosis?

• A. Jugular vein distention.
• B. Crackles in the lung bases.
• C. Peripheral edema.
• D. Bounding peripheral pulses.

Correct answer: B

Rationale: The correct answer is B: Crackles in the lung bases. Crackles in the lung bases are indicative of pulmonary congestion, which is a classic sign of left-sided heart failure. Left-sided heart failure leads to a backup of blood into the lungs, causing fluid leakage into the alveoli and resulting in crackles upon auscultation. Choices A, C, and D are less specific to left-sided heart failure. Jugular vein distention can be seen in right-sided heart failure, peripheral edema can be seen in both right and left-sided heart failure, and bounding peripheral pulses are more indicative of conditions like hyperthyroidism or anemia rather than specifically supporting left-sided heart failure.

3. When performing postural drainage on a client with chronic obstructive pulmonary disease (COPD), which approach should the nurse use?

• A. Obtain arterial blood gases (ABGs) before the procedure.
• B. Explain that the client may be positioned in five different ways.
• C. Assist the patient into a position that will allow gravity to move secretions.
• D. Encourage the client to practice deep breathing throughout the procedure.

Correct answer: C

Rationale: The correct approach when performing postural drainage on a client with COPD is to assist the patient into a position that allows gravity to help move secretions. This position helps drain secretions from specific segments of the lungs. Obtaining arterial blood gases (Choice A) is not directly related to postural drainage. While the client may be placed in multiple positions during postural drainage, the key is to position them to facilitate the movement of secretions, not just any five positions as mentioned in Choice B. Encouraging deep breathing (Choice D) is a good nursing intervention for overall respiratory health but is not specifically related to the technique of postural drainage.

4. What is the main characteristic of cystic fibrosis?

• A. Multiple upper respiratory infections
• B. An underproduction of exocrine glands
• C. Excessive, thick mucus
• D. An overproduction of thin mucus

Correct answer: C

Rationale: The main characteristic of cystic fibrosis is the production of excessive, thick mucus. This thick mucus leads to blockages in the airways, digestive system, and other organs. Choice A is incorrect because while individuals with cystic fibrosis are more prone to respiratory infections, the main characteristic is the mucus production. Choice B is incorrect as cystic fibrosis is characterized by the overproduction, not underproduction, of exocrine glands. Choice D is also incorrect as the mucus produced in cystic fibrosis is thick, not thin.

5. Based on this strip, what is the correct interpretation of this rhythm?

• A. Atrial fibrillation.
• B. Premature atrial fibrillation.
• C. AV block.
• D. Ventricular tachycardia.

Correct answer: A

Rationale: The correct interpretation of the rhythm strip is atrial fibrillation. This arrhythmia is characterized by an irregular heartbeat and the absence of distinct P waves. Choice B, premature atrial fibrillation, is incorrect as there is no indication of premature beats in the strip. Choice C, AV block, is also incorrect as there is no evidence of conduction delays between the atria and ventricles. Choice D, ventricular tachycardia, is not supported by the absence of wide QRS complexes typically seen in this arrhythmia.

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