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 most important nursing intervention for a patient with diarrhea?

• A. Encourage the patient to increase fluid intake.
• B. Monitor the patient's skin integrity.
• C. Check the patient's electrolyte levels.
• D. Educate the patient about infection control measures.

Correct answer: B

Rationale: The correct answer is to monitor the patient's skin integrity. This is crucial because diarrhea can lead to skin breakdown due to frequent bowel movements and increased moisture in the perineal area. By monitoring skin integrity, nurses can prevent skin breakdown, infection, and other associated issues. Encouraging fluid intake (Choice A) is important but not the most critical intervention. Checking electrolyte levels (Choice C) is essential but may not be the top priority at the onset. Educating the patient about infection control (Choice D) is important but secondary to preventing skin breakdown in a patient with diarrhea.

3. A family was referred to crisis intervention services after a natural disaster. One family member refuses to attend, stating, 'No way, I'm not crazy.' What is the nurse's best response?

• A. Don't worry now. The psychiatrists are well trained to help.
• B. Many times, disasters can create mental health problems, so you really should participate with your family.
• C. This will help your family communicate better.
• D. Seeking this kind of help does not mean that you have a mental illness; it is a short-term problem-solving technique.

Correct answer: D

Rationale: The nurse should reassure the family member that seeking help does not imply mental illness, but is part of coping with the disaster.

4. The nurse notes that a healthcare provider has prescribed a higher than normal dose of medication. What action should the nurse take?

• A. Administer the prescribed dose
• B. Ask another nurse to verify the dose
• C. Administer half of the dose
• D. Contact the healthcare provider to clarify the prescription

Correct answer: D

Rationale: When a healthcare provider prescribes a dose that is higher than normal, it is crucial for the nurse to contact the provider to clarify the prescription. Administering the prescribed dose without clarification can lead to potential harm to the patient due to the elevated dosage. Asking another nurse to verify the dose may not provide the necessary clarification from the prescriber. Administering only half of the prescribed dose without consulting the healthcare provider is not the appropriate action, as the full rationale behind the higher dose needs to be understood before any administration.

5. A client with diabetes mellitus is prescribed prednisone for a rash. Which statement by the client indicates the need for further teaching?

• A. I might have trouble falling asleep while taking prednisone
• B. I might feel emotional when I am on this medicine
• C. I might need to increase my regular insulin during this time
• D. I will gradually stop the prednisone when my rash goes away

Correct answer: D

Rationale: The correct answer is D. Prednisone should never be stopped abruptly; it must be tapered down. Stopping it suddenly can lead to adrenal insufficiency. Choices A, B, and C are all potential side effects or considerations when taking prednisone and do not indicate a need for further teaching.

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