Nursing Elites

1. What are the nursing interventions for a patient with COPD?

• A. Administer oxygen and provide breathing exercises
• B. Suction airway secretions and encourage coughing
• C. Administer bronchodilators and monitor oxygen saturation
• D. Restrict fluids and encourage mobility

Correct answer: A

Rationale: The correct answer is A: Administer oxygen and provide breathing exercises. These interventions are essential in managing COPD as they help improve lung function and oxygenation. Choice B is incorrect as suctioning airway secretions and encouraging coughing are not typically indicated for COPD patients. Choice C is incorrect as while administering bronchodilators is common in COPD treatment, monitoring oxygen saturation alone is not a comprehensive intervention. Choice D is incorrect as restricting fluids is not a standard intervention for COPD, and encouraging mobility, although beneficial, is not as directly related to managing COPD symptoms as administering oxygen and providing breathing exercises.

2. A client at 20 weeks of gestation is being taught by a nurse about an alpha-fetoprotein (AFP) test. Which of the following information should the nurse include?

• A. This test is used to confirm pregnancy
• B. This test is used to detect neural tube defects
• C. This test will determine the baby's lung maturity
• D. This test will check for gestational diabetes

Correct answer: B

Rationale: The correct answer is B: 'This test is used to detect neural tube defects.' An alpha-fetoprotein test is essential for screening neural tube defects in the fetus, not for confirming pregnancy, determining lung maturity, or checking for gestational diabetes. Detecting neural tube defects is crucial for early intervention and management of potential health issues in the baby.

3. What are the primary differences between left-sided and right-sided heart failure?

• A. Left-sided: Pulmonary congestion; Right-sided: Systemic edema
• B. Right-sided: Pulmonary congestion; Left-sided: Systemic edema
• C. Left-sided: Systemic edema; Right-sided: Pulmonary congestion
• D. Right-sided: Pulmonary congestion; Left-sided: Heart failure

Correct answer: A

Rationale: The correct answer is A: "Left-sided: Pulmonary congestion; Right-sided: Systemic edema." Left-sided heart failure primarily affects the lungs, leading to pulmonary congestion, which manifests as symptoms like shortness of breath and cough. On the other hand, right-sided heart failure causes systemic congestion and edema, often presenting as swelling in the legs and abdomen due to fluid retention. Choice B is incorrect because it swaps the features of left-sided and right-sided heart failure. Choice C is incorrect as it also incorrectly switches the characteristics of the two types of heart failure. Choice D is incorrect because it inaccurately associates left-sided heart failure with pulmonary congestion and right-sided heart failure with heart failure itself, which is not a distinguishing feature.

4. What are the key interventions for managing pneumonia?

• A. Administer antibiotics and monitor oxygen levels
• B. Administer bronchodilators and encourage deep breathing
• C. Provide fluids and monitor for dehydration
• D. Administer oxygen and provide bed rest

Correct answer: A

Rationale: The correct answer is A: Administer antibiotics and monitor oxygen levels. Antibiotics are essential to treat the infection caused by bacteria in pneumonia, while monitoring oxygen levels helps ensure adequate oxygenation. Administering bronchodilators and encouraging deep breathing, as in choice B, are more commonly associated with managing conditions like asthma or COPD, not pneumonia. Providing fluids and monitoring for dehydration, as in choice C, are important for various conditions but not specific to pneumonia management. Administering oxygen and providing bed rest, as in choice D, may be supportive measures in pneumonia treatment, but the key intervention is administering antibiotics.

5. A nurse is collecting data from a client who delivered a full-term newborn 16 hr ago. The nurse notes excessive lochia discharge. Which of the following actions should the nurse take first?

• A. Administer oxytocin
• B. Perform fundal massage
• C. Administer IV fluids
• D. Call the provider

Correct answer: B

Rationale: Performing fundal massage is the priority action in this scenario. Fundal massage helps contract the uterus, which is essential in reducing excessive lochia postpartum. Administering oxytocin may be indicated later, but fundal massage should be the initial intervention to address the issue. Administering IV fluids may not directly address the cause of excessive lochia, and calling the provider should come after implementing immediate nursing interventions.

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