Nursing Elites

1. The nurse supervises care of a client in Buck’s traction. The nurse determines that care is appropriate if which of the following is observed? (Select all that apply)

• A. The nurse removes the foam boot three times per day to inspect the skin
• B. The staff turn the client to the unaffected side
• C. The staff turn the client to the unaffected side and the nurse asks the client to dorsiflex the foot on the affected leg
• D. The nurse asks the client to dorsiflex the foot on the affected leg

Correct answer: C

Rationale: The correct answer is C. Turning the client to the unaffected side helps prevent complications such as pressure ulcers. Dorsiflexion of the foot on the affected leg helps maintain proper alignment and prevent foot drop. The incorrect choices are A and D. Removing the foam boot multiple times per day can disrupt traction, and asking the client to dorsiflex the foot may not be appropriate without ensuring proper alignment and direction from the healthcare provider.

2. The healthcare provider is conducting a respiratory assessment and is determining respirations per minute. Which factor(s) generally affect the character of respirations? Select all that apply.

• A. Anxiety
• B. Exercise
• C. Smoking
• D. A, B

Correct answer: D

Rationale: Correct! Anxiety and exercise can significantly alter the character of respirations, increasing the rate and depth. Smoking, while harmful to the respiratory system in the long term, does not directly affect the character of respirations like anxiety and exercise do. Therefore, choices C (Smoking) is incorrect. The correct answer is D (A, B).

3. During the admission interview, which question should the nurse ask the male client diagnosed with aorto-iliac disease?

• A. “Do you have trouble sitting for long periods of time?”
• B. “How often do you have a bowel movement and urinate?”
• C. “When you lie down do you feel throbbing in your abdomen?”
• D. “Have you experienced any problems having sexual intercourse?”

Correct answer: D

Rationale: The correct answer is D: “Have you experienced any problems having sexual intercourse?” Aorto-iliac disease can lead to impaired blood flow to the pelvis and lower extremities, potentially causing sexual dysfunction. The other choices (A, B, and C) are less relevant to the specific effects of aorto-iliac disease on the client's health. While choice A may relate to discomfort, it does not directly address the impact of the disease on sexual function. Choices B and C are more general and do not specifically target the potential issues related to aorto-iliac disease.

4. A nurse administers albuterol to a child with asthma. For what common side effect should the nurse monitor the child?

• A. Flushing
• B. Dyspnea
• C. Tachycardia
• D. Hypotension

Correct answer: C

Rationale: The correct answer is C, Tachycardia. Albuterol, a bronchodilator used to treat asthma, commonly causes tachycardia as a side effect. This occurs due to the medication's stimulatory effect on beta-2 adrenergic receptors. Flushing (Choice A) is not a common side effect of albuterol. Dyspnea (Choice B) refers to difficulty breathing, which is a symptom albuterol aims to alleviate. Hypotension (Choice D) is not typically associated with albuterol use; instead, albuterol can lead to an increase in blood pressure.

5. Which situation(s) are classified as natural disasters?

• A. Blizzards
• B. Blizzards, Volcanic eruptions
• C. Volcanic eruptions
• D. Structural collapse

Correct answer: B

Rationale: Blizzards and volcanic eruptions are classified as natural disasters because they are caused by natural forces beyond human control. In contrast, structural collapses are typically a result of man-made factors, making them not classified as natural disasters. Therefore, the correct answer is B.

Similar Questions