Nursing Elites

1. What are the key considerations for managing a patient with COPD?

• A. Bronchodilators
• B. Smoking cessation
• C. Pulmonary rehabilitation
• D. Oxygen therapy

Correct answer: D

Rationale: The key considerations for managing a patient with COPD include oxygen therapy, which is essential to maintain adequate oxygen saturation levels. While bronchodilators are commonly used to manage COPD symptoms, they are not the primary consideration. Smoking cessation is crucial in preventing further damage but is not a direct management consideration. Pulmonary rehabilitation is beneficial for improving exercise capacity and quality of life but is not as crucial as ensuring adequate oxygen therapy.

2. A nurse on an acute unit has received a change of shift report for 4 clients. Which of the following clients should the nurse assess first?

• A. A client who is 1 hr postoperative and has hypoactive bowel sounds.
• B. A client who has a fractured left tibia and pallor in the affected extremity.
• C. A client who had a cardiac catheterization 3 hr ago and has 3+ pedal pulses.
• D. A client who has an elevated AST level following the administration of azithromycin.

Correct answer: B

Rationale: The correct answer is B because pallor in an extremity after a fracture could indicate compromised circulation, making it a priority for assessment. Choice A is not the priority as hypoactive bowel sounds in a client 1 hr postoperative, while concerning, do not indicate a life-threatening condition. Choice C, a client who had a cardiac catheterization 3 hr ago and has 3+ pedal pulses, indicates good perfusion and does not require immediate attention. Choice D, a client with an elevated AST level following the administration of azithromycin, may require further assessment but is not as urgent as the client with potential compromised circulation in choice B.

3. What are the primary differences between Type 1 and Type 2 diabetes in terms of pathophysiology and treatment?

• A. Type 1: No insulin production; Type 2: Insulin resistance
• B. Type 1: Insulin resistance; Type 2: Insulin deficiency
• C. Type 1: Autoimmune; Type 2: Lifestyle-related
• D. Type 1: Insulin therapy; Type 2: Diet modification

Correct answer: A

Rationale: The correct answer is A. Type 1 diabetes is characterized by the absence of insulin production, while Type 2 diabetes involves insulin resistance. Choice B is incorrect because Type 1 diabetes is not related to insulin resistance. Choice C is inaccurate as Type 1 diabetes is autoimmune while Type 2 diabetes is more associated with lifestyle factors. Choice D is not correct since insulin therapy is primarily used in Type 1 diabetes, whereas diet modification is a common approach in managing Type 2 diabetes.

4. The nurse is caring for a manic client in the seclusion room, and it is time for lunch. It is MOST appropriate for the nurse to take which of the following actions?

• A. Take the client to the dining room with 1:1 supervision
• B. Inform the client they may go to the dining room when they control their behavior
• C. Hold the meal until the client is able to come out of seclusion
• D. Serve the meal to the client in the seclusion room

Correct answer: D

Rationale: In the scenario described, the manic client is in the seclusion room, and it is most appropriate for the nurse to serve the meal to the client in the seclusion room. This action helps maintain the client's nutritional needs while managing their behavior. Taking the client to the dining room with 1:1 supervision (Choice A) may pose safety risks both for the client and others. Informing the client they may go to the dining room when they control their behavior (Choice B) may not be feasible in a manic state. Holding the meal until the client is able to come out of seclusion (Choice C) can lead to nutritional deficiencies and does not address the immediate need for nutrition during the episode of mania.

5. Which term specifically refers to positive actions taken to help others?

• A. Beneficence
• B. Justice
• C. Autonomy
• D. Non-maleficence

Correct answer: A

Rationale: The correct answer is A, 'Beneficence.' Beneficence is the ethical principle that involves taking positive actions to help others. Choice B, 'Justice,' pertains to fairness and equity in treatment, not specifically positive actions. Choice C, 'Autonomy,' relates to respecting individuals' rights to make their own decisions, not necessarily taking actions to help others. Choice D, 'Non-maleficence,' focuses on the obligation to avoid causing harm rather than actively helping others.

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