Nursing Elites

1. The nurse is teaching a 27-year-old client with asthma about the management of their therapeutic regimen. Which statement would indicate the need for additional instruction?

• A. ''I should monitor my peak flow every day.''
• B. ''I should contact the clinic if I am using my medication more often.''
• C. ''I need to limit my exercise, especially activities such as walking and running.''
• D. ''I should learn stress reduction and relaxation techniques.''

Correct answer: C

Rationale: Exercise, especially aerobic activities, is beneficial for clients with asthma as long as it is well-managed. Limiting exercise is not generally recommended unless specifically advised by a healthcare provider, indicating a need for further instruction in this case. Monitoring peak flow, contacting the clinic for increased medication use, and learning stress reduction techniques are all appropriate self-management strategies for asthma, indicating good understanding by the client.

2. An infant has just returned from surgery for placement of a gastrostomy tube as an initial treatment for tracheoesophageal fistula. The mother asks, 'When can the tube be used for feeding?' The nurse's best response would be which of these comments?

• A. "Feedings can begin in 5 to 7 days."
• B. "The use of the feeding tube can begin immediately."
• C. "The stomach contents and air must be drained first."
• D. "The incision healing must be complete before feeding."

Correct answer: C

Rationale: The correct answer is C: 'The stomach contents and air must be drained first.' Before starting feedings through a gastrostomy tube, it is essential to drain the stomach contents and air. This process helps prevent complications and ensures the proper functioning of the tube after placement. Choice A is incorrect because initiating feedings within 5 to 7 days may lead to complications if the stomach is not adequately prepared. Choice B is incorrect as feeding should not begin immediately to allow for proper preparation of the tube and the stomach. Choice D is incorrect because although incision healing is important, draining the stomach contents and air is a more immediate concern to prevent complications.

3. Postoperative orders for a client undergoing a mitral valve replacement include monitoring pulmonary artery pressure together with pulmonary capillary wedge pressure with a pulmonary artery catheter. This action by the nurse will assess

• A. Right ventricular pressure
• B. Left ventricular end-diastolic pressure
• C. Acid-Base balance
• D. Coronary artery stability

Correct answer: B

Rationale: The correct answer is B: Left ventricular end-diastolic pressure. Pulmonary capillary wedge pressure is used to assess left ventricular end-diastolic pressure. This measurement provides valuable information on the filling pressure of the left ventricle. Choices A, C, and D are incorrect because monitoring pulmonary capillary wedge pressure does not directly assess right ventricular pressure, acid-base balance, or coronary artery stability.

4. At a routine health assessment, a client tells the nurse that she is planning a pregnancy in the near future. She asks about preconception diet changes. Which of the statements made by the nurse is best?

• A. Include fibers in your daily diet.
• B. Increase green leafy vegetable intake.
• C. Drink a glass of milk with each meal.
• D. Eat at least 1 serving of fish weekly.

Correct answer: B

Rationale: The correct answer is B: "Increase green leafy vegetable intake." This is the best advice because green leafy vegetables are rich in folic acid, which is essential for fetal development and helps prevent neural tube defects. Choice A is not specific enough and does not address the importance of folic acid. Choice C, drinking milk with each meal, does not provide the necessary folic acid intake. Choice D, eating fish weekly, is not as crucial for preconception diet changes as increasing folic acid intake.

5. What is the ability to obtain, process, and understand basic health information and services needed to make appropriate health decisions known as?

• A. Health literacy
• B. Health equity
• C. Health disparity
• D. Health promotion

Correct answer: A

Rationale: Health literacy refers to the ability to obtain, process, and understand basic health information and services necessary to make informed health decisions. It empowers individuals to navigate the healthcare system, understand medical instructions, and advocate for their own health needs. - Choice B, Health equity, is the concept of everyone having a fair opportunity to attain their full health potential and not being disadvantaged due to their social or economic status. - Choice C, Health disparity, refers to differences in health outcomes or access to healthcare between different populations, often influenced by social, economic, or environmental factors. - Choice D, Health promotion, involves efforts to enhance and protect the health of individuals and communities through education, behavior change, and public health initiatives.

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