Nursing Elites

1. The nurse is planning care for a client with pneumococcal pneumonia. Which of the following would be most effective in removing respiratory secretions?

• A. Administration of cough suppressants
• B. Increasing oral fluid intake to 3000 cc per day
• C. Maintaining bed rest with bathroom privileges
• D. Performing chest physiotherapy twice a day

Correct answer: B

Rationale: Increasing oral fluid intake to 3000 cc per day is the most effective in removing respiratory secretions in a client with pneumococcal pneumonia. Adequate hydration helps thin secretions, making them easier to expectorate. Administration of cough suppressants (Choice A) may hinder the removal of secretions by suppressing the cough reflex. Maintaining bed rest with bathroom privileges (Choice C) is important but does not directly address the removal of respiratory secretions. Performing chest physiotherapy (Choice D) is beneficial for mobilizing secretions but may not be as effective as increasing fluid intake in thinning and facilitating the removal of secretions.

2. A client with a history of alcoholism is admitted to the hospital for detoxification. The nurse knows that the client's risk for withdrawal symptoms is greatest within:

• A. 2-4 hours
• B. 4-6 hours
• C. 6-12 hours
• D. 12-24 hours

Correct answer: D

Rationale: The correct answer is D: 12-24 hours. Withdrawal symptoms typically begin within 12-24 hours after the last drink. This period is when the client is at the highest risk for experiencing withdrawal symptoms. Choices A, B, and C are incorrect because they do not align with the typical timeline for alcohol withdrawal symptoms to manifest. Symptoms usually peak within the first 24 to 48 hours after the last drink, making the 12-24 hour window critical for monitoring and managing any potential withdrawal complications.

3. Which ethnic group has the highest risk for diabetes?

• A. African Americans
• B. Hispanic Americans
• C. Asian Americans
• D. Native Americans

Correct answer: D

Rationale: Native Americans have the highest risk for diabetes compared to other ethnic groups. This is due to genetic predisposition, lifestyle factors, and limited access to healthcare. African Americans, Hispanic Americans, and Asian Americans also have an increased risk of developing diabetes, but statistically, Native Americans have the highest prevalence of the disease. Therefore, choices A, B, and C are incorrect.

4. Which of the following is a key component of community-based participatory research?

• A. Conducting research in a laboratory setting
• B. Involving community members in the research process
• C. Focusing solely on quantitative data
• D. Ignoring community input

Correct answer: B

Rationale: The correct answer is B: 'Involving community members in the research process.' Community-based participatory research emphasizes the active involvement of community members in all aspects of the research process, from identifying research questions to interpreting and disseminating results. Choice A is incorrect because community-based participatory research typically takes place in real-world settings, not in laboratories. Choice C is incorrect because community-based participatory research values a mix of quantitative and qualitative data. Choice D is incorrect because community input is essential in this research approach.

5. A client with a peptic ulcer is scheduled for a vagotomy and pyloroplasty. The nurse explains that the purpose of this surgery is to:

• A. Increase acid secretion
• B. Reduce acid secretion
• C. Promote gastric emptying
• D. Remove the ulcerated area

Correct answer: B

Rationale: The correct answer is B: "Reduce acid secretion." Vagotomy is performed to reduce acid secretion by cutting the vagus nerve, which stimulates acid production. Choices A, C, and D are incorrect. A vagotomy does not increase acid secretion, promote gastric emptying, or remove the ulcerated area. It specifically aims to decrease acid production to help in the healing of peptic ulcers.

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