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 client has a new prescription for clopidogrel. Which of the following instructions should the nurse include?

• A. Take this medication with food
• B. Take this medication three times daily
• C. You might have to stop taking this medication 5 days before any planned surgeries
• D. Expect to have black-colored stools while taking this medication

Correct answer: C

Rationale: The correct answer is C. When instructing a client who is prescribed clopidogrel, the nurse should include information about stopping the medication 5 days before any planned surgeries to reduce the risk of bleeding. This is crucial to prevent excessive bleeding during surgical procedures. Choices A, B, and D are incorrect because taking the medication with food, the frequency of administration, and the possibility of black-colored stools are not specific instructions related to clopidogrel use.

3. 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.

4. A patient has a DNR (do-not-resuscitate) order but their family insists on resuscitation if necessary. What should the nurse do?

• A. Follow the family's wishes to resuscitate.
• B. Explain that the nurse must follow the DNR order.
• C. Ask the provider for clarification on the DNR.
• D. Call the ethics committee to discuss the situation.

Correct answer: B

Rationale: The correct answer is B. The nurse must follow the legal DNR order, even if the family insists on resuscitation. Respecting the patient's wishes is crucial in providing ethical care. Choice A is incorrect because the nurse should prioritize the patient's documented wishes over the family's requests. Choice C may cause unnecessary delays in care as the DNR order is a legal document. Choice D is not the initial action to take in this situation; the nurse should first address the conflict between the family's wishes and the patient's DNR order.

5. An occupational health nurse in a factory is planning interventions to reduce environmental stressors for employees. Which of the following interventions should the nurse use to affect physical agents in the environment?

• A. Teach workers to choose personal strategies to cope with work stress
• B. Limit the amount of time workers spend in temperatures over 43.3°C (110°F)
• C. Provide ear plugs for use at workstations throughout the factory
• D. Obtain dosimeters for employees to wear when using new machinery that emits radiation

Correct answer: B

Rationale: Limiting exposure to extreme temperatures is important to protect workers from heat-related illnesses.

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