Nursing Elites

1. What are the nursing considerations when caring for a patient with chronic obstructive pulmonary disease (COPD)?

• A. Encouraging pursed-lip breathing to improve ventilation
• B. Administering bronchodilators and corticosteroids
• C. Monitoring oxygen saturation and ABGs
• D. Teaching the patient how to use an inhaler

Correct answer: A

Rationale: The correct answer is A. Pursed-lip breathing is a nursing consideration for patients with COPD as it helps improve oxygenation and reduces air trapping. While administering bronchodilators and corticosteroids (choice B) is part of the treatment plan, it is typically done by healthcare providers. Monitoring oxygen saturation and arterial blood gases (ABGs) (choice C) is important but not a direct nursing consideration. Teaching the patient how to use an inhaler (choice D) is relevant but not specific to COPD care.

2. What is the nurse's priority intervention for a patient who has developed a pressure ulcer?

• A. Apply a dressing to the ulcer.
• B. Reposition the patient every 2 hours.
• C. Provide the patient with pain medication.
• D. Clean the ulcer with normal saline.

Correct answer: B

Rationale: The correct answer is to reposition the patient every 2 hours. Repositioning helps prevent the worsening of pressure ulcers by relieving pressure on affected areas and promoting blood circulation, which aids in healing. Applying a dressing (choice A) is important but not the priority compared to repositioning. Providing pain medication (choice C) is essential for comfort but does not address the root cause of the pressure ulcer. Cleaning the ulcer with normal saline (choice D) is part of wound care but does not take precedence over repositioning to prevent further tissue damage.

3. A healthcare professional in a clinic sees a client who has an acute asthma exacerbation. Which of the following medications should reduce the symptoms?

• A. Cromolyn via metered dose inhaler
• B. Budesonide via dry powder inhaler
• C. Montelukast orally
• D. Albuterol via jet nebulizer

Correct answer: D

Rationale: Albuterol via jet nebulizer is the correct choice in this scenario as it is a short-acting bronchodilator that quickly relieves bronchospasm during an asthma exacerbation. Cromolyn (Choice A) is a mast cell stabilizer used for prevention, not quick relief. Budesonide (Choice B) is an inhaled corticosteroid used for long-term control, not for acute symptom relief. Montelukast (Choice C) is a leukotriene receptor antagonist used for maintenance therapy, not for immediate symptom relief during an exacerbation.

4. What are the main differences between a stroke caused by ischemia and one caused by hemorrhage?

• A. Blockage in a blood vessel supplying the brain
• B. Bleeding in the brain due to a ruptured aneurysm
• C. Administering thrombolytics if within the treatment window
• D. Avoiding anticoagulants and preparing for surgery

Correct answer: A

Rationale: The correct answer is A: "Blockage in a blood vessel supplying the brain." Ischemic stroke is caused by a blockage in a blood vessel supplying the brain, leading to reduced blood flow. Hemorrhagic stroke, on the other hand, is caused by bleeding in the brain due to a ruptured blood vessel. Choices B, C, and D are incorrect. Administering thrombolytics, avoiding anticoagulants, and preparing for surgery are specific management strategies that may apply to ischemic or hemorrhagic strokes but do not define the main differences between the two types of strokes.

5. A nurse is preparing to administer furosemide 40 mg IV. Available is furosemide 10 mg/1 mL. How many mL should the nurse administer per dose?

• A. 2
• B. 3
• C. 4
• D. 5

Correct answer: C

Rationale: To calculate the mL needed, divide the total dose by the dose per mL. In this case, 40 mg divided by 10 mg/mL equals 4 mL. Therefore, the nurse should administer 4 mL per dose. Choice A, 2 mL, is incorrect because it would only deliver 20 mg of furosemide, which is half the required dose. Choices B and D are also incorrect as they do not provide the accurate amount needed to achieve the 40 mg dosage.

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