Nursing Elites

1. The wife of a client with Parkinson's disease expresses concern because her husband has lost so much weight. Which teaching is best for the nurse to provide?

• A. Invite friends over regularly to share meal times
• B. Encourage the client to drink clear liquids between meals
• C. Coach the client to make an intentional effort to swallow
• D. Talk to the healthcare provider about prescribing an appetite stimulant

Correct answer: A

Rationale: The best teaching for the nurse to provide is to invite friends over regularly to share meal times. This can help in making meal times more enjoyable for the client with Parkinson's disease, potentially encouraging him to eat more. Encouraging clear liquids between meals (choice B) may not address the underlying issue of weight loss. Coaching the client to make an intentional effort to swallow (choice C) may not be effective if the weight loss is due to other factors related to Parkinson's disease. While prescribing an appetite stimulant (choice D) could be an option, it is usually recommended to explore non-pharmacological interventions first, making choice A the most appropriate initial teaching intervention.

2. A client who is newly diagnosed with emphysema is being prepared for discharge. Which instruction is best for the nurse to provide the client to assist them with dyspnea self-management?

• A. Allow additional time to complete physical activities to reduce oxygen demand.
• B. Practice inhaling through the nose and exhaling slowly through pursed lips.
• C. Use a humidifier to increase home air quality humidity between 30-50%.
• D. Strengthen abdominal muscles by alternating leg raises during exhalation.

Correct answer: B

Rationale: The correct answer is B. Instructing the client to practice inhaling through the nose and exhaling slowly through pursed lips can help improve oxygenation and reduce dyspnea. This technique, known as pursed lip breathing, can help regulate breathing patterns and decrease the work of breathing in clients with emphysema. Choice A is incorrect because allowing additional time for physical activities does not directly address dyspnea management. Choice C is incorrect as using a humidifier, although beneficial for respiratory conditions, does not specifically assist with dyspnea self-management. Choice D is also incorrect as strengthening abdominal muscles through leg raises does not directly target dyspnea relief.

3. The nurse explains to the parents of a child with developmental hip dysplasia that the application of a Pavlik harness is necessary. In what position will the harness hold the child's femurs?

• A. Abduction
• B. Adduction
• C. Flexion
• D. Extension

Correct answer: A

Rationale: The correct answer is A: Abduction. The use of the Pavlik harness is to maintain the hips in abduction for 4 to 6 months to treat developmental hip dysplasia. This position helps in stabilizing the hip joint and promoting proper growth and development. Choices B, C, and D are incorrect because the Pavlik harness specifically aims to hold the child's femurs in abduction, not adduction, flexion, or extension.

4. A client is receiving a secondary infusion of erythromycin 1 gram in 100 mL dextrose 5% in water (D5W) to be infused in 45 minutes. How many mL/hour should the nurse program the infusion pump?

• A. 100 mL/hour.
• B. 125 mL/hour.
• C. 133 mL/hour.
• D. 150 mL/hour.

Correct answer: C

Rationale: To infuse 100 mL in 45 minutes, the infusion rate should be set to 133 mL/hour (100 mL / 0.75 hours). This calculation is obtained by dividing the total volume to be infused by the total time for infusion (100 mL / 0.75 hours = 133 mL/hour). Therefore, choice C is the correct answer. Choices A, B, and D are incorrect because they do not accurately calculate the infusion rate required to deliver the medication within the specified time frame.

5. What is a causative factor of Hirschsprung disease?

• A. Frequent evacuation of solids, liquid, and gases
• B. Excessive peristaltic movement
• C. The absence of parasympathetic ganglion cells in a portion of the colon
• D. One portion of the bowel telescoping into another

Correct answer: C

Rationale: The correct answer is C: The absence of parasympathetic ganglion cells in a portion of the colon is a causative factor of Hirschsprung disease. This absence leads to the inability of the affected segment of the colon to relax, causing a functional obstruction. Choices A, B, and D are incorrect. Frequent evacuation of solids, liquid, and gases, excessive peristaltic movement, and one portion of the bowel telescoping into another are not causative factors of Hirschsprung disease.

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