Nursing Elites

1. Which of the following is a common cause of chronic obstructive pulmonary disease (COPD)?

• A. Smoking
• B. Asthma
• C. Allergies
• D. Chronic bronchitis

Correct answer: A

Rationale: Smoking is the correct answer as it is a well-established common cause of chronic obstructive pulmonary disease (COPD). Smoking leads to long-term damage to the lungs, contributing to the development of COPD. Choice B, asthma, is not a cause but a separate respiratory condition characterized by airway inflammation and hyperresponsiveness. Allergies, choice C, are not a direct cause of COPD but can exacerbate symptoms in individuals with existing COPD. Chronic bronchitis, choice D, is a type of COPD, not a cause of COPD itself, making it an incorrect choice in this context.

2. A patient has begun taking spironolactone (Aldactone) in addition to a thiazide diuretic. With the addition of the spironolactone, the nurse will counsel this patient to

• A. not take a potassium supplement daily.
• B. recognize that abdominal cramping is a common side effect.
• C. report decreased urine output to the provider.
• D. take these medications in the morning.

Correct answer: C

Rationale: When combining a potassium-sparing diuretic like spironolactone with a thiazide diuretic, there is an increased risk of hyperkalemia, especially in patients with poor renal function. Therefore, the patient should be educated to report any decrease in urine output, which could indicate a potential issue with kidney function. Choice A is incorrect because taking additional potassium supplements can further increase the risk of hyperkalemia. Choice B is incorrect as abdominal cramping is not a common side effect of spironolactone. Choice D is incorrect because the timing of medication administration is not directly related to the addition of spironolactone and thiazide diuretic; there is no specific recommendation to take these medications only at bedtime.

3. The best indicator that the client has learned how to give an insulin self-injection correctly is when the client can:

• A. Perform the procedure safely and correctly.
• B. Critique the nurse's performance of the procedure.
• C. Explain all steps of the procedure correctly.
• D. Correctly answer a posttest about the procedure.

Correct answer: A

Rationale: The correct answer is A. Learning is best demonstrated by a change in behavior. A client who can safely and correctly perform the procedure shows they have acquired the skill. Choice B is incorrect because critiquing the nurse's performance does not directly demonstrate the client's ability to perform the procedure. Choice C is incorrect because explaining the steps does not guarantee the client can physically perform the injection. Choice D is incorrect as answering a posttest only assesses theoretical knowledge, not practical application.

4. A nurse cares for adult clients who experience urge incontinence. For which client should the nurse plan a habit training program?

• A. A 78-year-old female who is confused
• B. A 65-year-old male with diabetes mellitus
• C. A 52-year-old female with kidney failure
• D. A 47-year-old male with arthritis

Correct answer: A

Rationale: For a bladder training program to succeed in a client with urge incontinence, the client must be alert, aware, and able to resist the urge to urinate. Habit training will work best for a confused client. This includes going to the bathroom (or being assisted to the bathroom) at set times. The other clients may benefit from other types of bladder training. A confused client may need structured assistance to establish a regular bathroom routine, which can help manage urge incontinence effectively. Clients with diabetes mellitus, kidney failure, or arthritis may require different strategies tailored to their specific conditions.

5. A healthcare professional is reviewing the results of renal function testing in a client with renal calculi. Which finding indicates to the healthcare professional that the client’s blood urea nitrogen (BUN) level is within the normal range?

• A. 2 mg/dL
• B. 18 mg/dL
• C. 25 mg/dL
• D. 35 mg/dL

Correct answer: B

Rationale: The normal BUN ranges from 5 to 20 mg/dL. A BUN level of 18 mg/dL falls within this normal range. Values of 25 and 35 mg/dL are elevated, suggesting potential renal insufficiency. Choice A (2 mg/dL) is abnormally low and not indicative of a normal BUN level.

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