Nursing Elites

1. What is the best position for a patient with respiratory distress?

• A. Semi-Fowler's position
• B. Trendelenburg position
• C. Prone position
• D. Supine position

Correct answer: A

Rationale: The best position for a patient with respiratory distress is the Semi-Fowler's position. This position promotes lung expansion and improves oxygenation by allowing the chest to expand more fully. The Trendelenburg position, where the patient's feet are higher than the head, is contraindicated in respiratory distress as it can increase pressure on the diaphragm and compromise breathing. The prone position, lying face down, may be beneficial in certain cases like acute respiratory distress syndrome but is not generally recommended for all patients in respiratory distress. The supine position, lying flat on the back, can worsen respiratory distress by causing the tongue to fall back and obstruct the airway.

2. What is the initial step when a patient is experiencing chest pain?

• A. Administer oxygen
• B. Reposition the patient
• C. Provide pain relief
• D. Provide nitroglycerin

Correct answer: A

Rationale: Administering oxygen is the initial step in managing chest pain. Oxygen helps improve oxygenation levels in the blood, which is crucial in cases of chest pain. Repositioning the patient, providing pain relief, or administering nitroglycerin may be necessary steps depending on the underlying cause, but administering oxygen takes precedence as it addresses the primary concern of oxygen supply to the body during chest pain.

3. A nurse is providing discharge teaching to a client who is postoperative following a total hip arthroplasty. Which of the following instructions should the nurse include?

• A. Cross your legs when sitting to increase circulation.
• B. Bend at the waist when picking up objects.
• C. Avoid crossing your legs when sitting.
• D. Avoid using a raised toilet seat.

Correct answer: C

Rationale: The correct answer is C: 'Avoid crossing your legs when sitting.' After a total hip arthroplasty, it is important for clients to avoid crossing their legs to prevent complications such as dislocation. Crossing the legs can put strain on the new hip joint, increasing the risk of dislocation. Choice A is incorrect as crossing legs can be harmful. Choice B is incorrect as bending at the waist can strain the hip joint, leading to complications. Choice D is incorrect as using a raised toilet seat is recommended after hip surgery to prevent excessive bending at the hip joint.

4. What is the best method to monitor fluid balance in a patient receiving diuretics?

• A. Monitor daily weight
• B. Monitor intake and output
• C. Monitor blood pressure
• D. Monitor edema

Correct answer: A

Rationale: The best method to monitor fluid balance in a patient receiving diuretics is to monitor daily weight. Daily weighing is a precise way to assess changes in fluid status as it reflects variations in total body water. Monitoring intake and output (choice B) is also important but may not provide as accurate a measurement as daily weight. Monitoring blood pressure (choice C) is essential but does not directly measure fluid balance. Monitoring edema (choice D) is helpful to assess fluid status visually but may not be as sensitive as daily weight measurements in detecting subtle changes in fluid balance.

5. A client has a new prescription for nitroglycerin sublingual tablets. Which of the following instructions should the nurse include?

• A. Take a tablet every 5 minutes for pain relief, up to three doses.
• B. Take this medication with a glass of water.
• C. Chew the tablet for faster absorption.
• D. Store the tablets in a refrigerator.

Correct answer: A

Rationale: The correct answer is A: 'Take a tablet every 5 minutes for pain relief, up to three doses.' Nitroglycerin sublingual tablets are used to relieve chest pain or to prevent chest pain before activities known to cause angina. The tablets should be taken every 5 minutes for pain relief, up to three doses, as prescribed. Choice B is incorrect because nitroglycerin sublingual tablets should be placed under the tongue until they dissolve, not taken with water. Choice C is incorrect because nitroglycerin sublingual tablets should not be chewed but placed under the tongue for absorption. Choice D is incorrect because nitroglycerin tablets should be stored in their original container at room temperature away from light and moisture.

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