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. 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.

3. A client undergoing surgery refuses to remove religious jewelry. What is the best course of action?

• A. Proceed with surgery while securing the jewelry to the patient.
• B. Remove the jewelry and document the removal.
• C. Document the refusal and delay the surgery.
• D. Remove the jewelry with the family's permission.

Correct answer: B

Rationale: The correct course of action is to remove the jewelry and document the removal. While religious beliefs should be respected, ensuring patient safety during surgery is crucial. Securing the jewelry may not be sufficient to prevent any interference during the surgical procedure. Documenting the removal is important for legal and documentation purposes. Delaying the surgery or removing the jewelry with the family's permission may not be the best options as patient safety should be the top priority in this situation.

4. A nurse is evaluating a client receiving hemodialysis. Which of the following lab values requires immediate intervention?

• A. Sodium 135 mEq/L
• B. Potassium 6.5 mEq/L
• C. Calcium 9 mg/dL
• D. Chloride 98 mEq/L

Correct answer: B

Rationale: The correct answer is B. Potassium levels above 5.0 mEq/L can lead to cardiac issues, and a level of 6.5 mEq/L requires immediate intervention. Hyperkalemia can cause life-threatening cardiac arrhythmias. Choices A, C, and D are within normal ranges and do not require immediate intervention in the context of hemodialysis monitoring.

5. A healthcare professional in a clinic sees a client who has an acute asthma exacerbation. Which of the following medications should reduce the symptoms?

• A. Cromolyn via metered dose inhaler
• B. Budesonide via dry powder inhaler
• C. Montelukast orally
• D. Albuterol via jet nebulizer

Correct answer: D

Rationale: Albuterol via jet nebulizer is the correct choice in this scenario as it is a short-acting bronchodilator that quickly relieves bronchospasm during an asthma exacerbation. Cromolyn (Choice A) is a mast cell stabilizer used for prevention, not quick relief. Budesonide (Choice B) is an inhaled corticosteroid used for long-term control, not for acute symptom relief. Montelukast (Choice C) is a leukotriene receptor antagonist used for maintenance therapy, not for immediate symptom relief during an exacerbation.

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