Nursing Elites

1. What is the primary goal when caring for a patient with chronic obstructive pulmonary disease (COPD)?

• A. Maintain the patient's oxygen saturation above 90%.
• B. Administer bronchodilators as prescribed.
• C. Improve the patient's nutritional intake.
• D. Encourage the patient to limit physical activity.

Correct answer: A

Rationale: The correct answer is to maintain the patient's oxygen saturation above 90% when caring for a patient with COPD. In COPD, impaired gas exchange leads to decreased oxygen levels in the blood. By ensuring oxygen saturation remains above 90%, healthcare providers can prevent hypoxia and its complications. Administering bronchodilators as prescribed (Choice B) is an important intervention in managing COPD symptoms, but it is not the primary goal. Improving the patient's nutritional intake (Choice C) and encouraging the patient to limit physical activity (Choice D) are also essential aspects of COPD management, but they are not the primary goal when caring for a patient with this condition.

2. A nurse is preparing to administer verapamil to a client who is 2 days postmyocardial infarction. The nurse should monitor the client for which of the following outcomes as a therapeutic response to the medication?

• A. Decreased blood pressure
• B. Decreased anginal pain
• C. Decreased heart rate
• D. Decreased anxiety

Correct answer: B

Rationale: The correct answer is B: Decreased anginal pain. Verapamil is a calcium channel blocker used to relieve angina by reducing myocardial oxygen demand. Monitoring for decreased anginal pain is essential as it indicates a therapeutic response to the medication. Choices A, C, and D are incorrect as verapamil's primary goal in this context is not to decrease blood pressure, heart rate, or anxiety.

3. A client is preparing for surgery wearing a necklace. What is the appropriate action?

• A. Remove the necklace and place it in a drawer
• B. Tape the necklace to the patient's skin
• C. Ask the patient for permission to lock it in a safe
• D. Ask the family to hold onto the necklace

Correct answer: C

Rationale: The appropriate action when a client is wearing a necklace before surgery is to ask the patient for permission to lock it in a safe. This is in line with hospital policy to secure valuables before entering surgery. Choice A is incorrect because simply placing the necklace in a drawer may not be secure. Choice B is incorrect as taping the necklace to the patient's skin can cause skin irritation and is not a standard practice. Choice D is incorrect because the responsibility for securing valuables typically lies with the healthcare team, not the patient's family.

4. A client with renal calculi is admitted. What is the priority nursing intervention?

• A. Monitor urinary output every shift.
• B. Administer pain medication as ordered.
• C. Strain all urine for stones.
• D. Increase fluid intake to flush the urinary tract.

Correct answer: C

Rationale: The correct answer is to strain all urine for stones. This is the priority nursing intervention for a client with renal calculi as it helps in identifying and preventing stones from passing unnoticed. Monitoring urinary output, administering pain medication, and increasing fluid intake are important aspects of care for this client, but the priority is to ensure that any passed stones are collected and analyzed to guide further treatment.

5. A patient has difficulty ambulating after surgery. Which action should the nurse take first?

• A. Encourage deep breathing exercises.
• B. Assist the patient in ambulating a short distance.
• C. Call for assistance with ambulation.
• D. Assess the patient's pain level before ambulation.

Correct answer: C

Rationale: The correct first action for the nurse to take when a patient has difficulty ambulating after surgery is to call for assistance with ambulation. This is essential to ensure the safety of the patient and prevent any potential falls or injuries. Encouraging deep breathing exercises (Choice A) may be beneficial but should not be the first priority when the patient is having difficulty walking. Assisting the patient in ambulating a short distance (Choice B) may put both the patient and the nurse at risk if the patient is struggling. Assessing the patient's pain level before ambulation (Choice D) is important but should come after ensuring that the patient can safely ambulate with assistance.

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