General Nursing Things
What is asthma?
Asthma is a chronic inflammatory disorder of the airways characterized by reversible airflow obstruction and bronchial hyperresponsiveness.
Name three common signs and symptoms of asthma.
Wheezing, shortness of breath, and chest tightness.
What is the first-line medication used during an acute asthma exacerbation?
Short-acting beta-2 agonists (SABA), such as albuterol.
What is the definition of Clinical Governance?
Clinical Governance is a comprehensive framework that ensures continuous improvement in patient care, emphasizing patient safety, accountability, transparency, and quality standards
According to Ellis & Hartley (2010), how is leadership defined in nursing?
Leadership is the process of guiding, teaching, motivating, and directing the activities of others toward attaining goals
What causes the airway narrowing in asthma?
Airway narrowing is caused by inflammation, bronchoconstriction, and excess mucus production.
During an asthma attack, why might a patient have difficulty speaking full sentences?
Severe bronchoconstriction and airflow limitation reduce the ability to exhale effectively.
Rationale: Impaired ventilation compromises oxygenation and speech.
In severe asthma attacks, what additional medication class may be administered besides SABA?
Systemic corticosteroids (e.g., prednisone).
Rationale: Corticosteroids reduce airway inflammation and prevent worsening symptoms.
In what year was Clinical Governance formally introduced into the National Health Service (NHS), and why?
It was formally introduced in 1998 as part of NHS reforms, in response to high-profile failures such as the Bristol Royal Infirmary scandal and Dr. Harold Shipman
What is the main idea behind the Great Man Theory of leadership?
It suggests that certain individuals are born with innate traits—such as charisma, intelligence, and wisdom—that make them natural leaders
What position should a nurse place a patient in during an asthma exacerbation?
High Fowler’s position.
Rationale: Upright positioning maximizes lung expansion and eases breathing.
What lung sound is most commonly heard in asthma exacerbation?
Expiratory wheezing.
Rationale: Wheezing results from air moving through narrowed bronchial passages.
What is the most effective long-term controller medication for persistent asthma?
Inhaled corticosteroids (ICS).
Rationale: ICS decrease airway inflammation and reduce exacerbation frequency.
Name three essential components of Clinical Governance that directly impact nursing practice.
Clinical leadership
Evidence-based practice
Patient-centered care
(others include quality & safety, performance monitoring, and risk management)
Which leadership theory emphasizes the ability to identify and manage one’s own emotions and the emotions of others?
Emotional Intelligence theory
Emotional Intelligence is the ability to recognize, understand, manage, and influence emotions in yourself and in others. In leadership, it goes beyond technical or intellectual skills — it emphasizes self-awareness and interpersonal effectiveness.
What teaching should nurses provide about asthma triggers?
Identify and avoid triggers such as allergens, smoke, cold air, or exercise.
Rationale: Trigger avoidance is essential in preventing exacerbations.
During an asthma exacerbation, what physical sign might you observe in a child that indicates increased work of breathing?
Use of accessory muscles (such as intercostal retractions or nasal flaring).
Rationale: Children compensate for airway obstruction by using extra muscles to breathe, which is an early sign of respiratory distress.
What is a common side effect of inhaled corticosteroids?
Oral thrush (candidiasis).
Rationale: ICS suppress local immunity in the mouth, allowing fungal overgrowth.
How does Clinical Governance empower nurses to contribute to healthcare quality and safety?
Clinical Governance empowers nurses by promoting evidence-based practice, supporting continuous improvement, encouraging patient-centered care, and involving nurses in leadership, risk management, and performance monitoring
Compare Autocratic and Democratic leadership styles in terms of decision-making and staff involvement.
Autocratic leadership involves strong control, top-down decision-making, and little staff input. Democratic leadership involves collaboration, shared decision-making, and emphasizes communication and teamwork
A patient with asthma insists on continuing to smoke despite repeated education and has been non-compliant with their daily inhaled corticosteroid. They present to the ER in severe respiratory distress. What should the nurse prioritize in this situation?
Provide immediate life-saving interventions (administer oxygen, SABA, and follow acute exacerbation protocol) before addressing non-compliance issues.
A nurse is performing a respiratory assessment on a patient in acute asthma exacerbation. The nurse notes audible wheezing, use of accessory muscles, and oxygen saturation of 88% on room air. The patient is anxious and speaking in short phrases. What is the priority nursing action?
Administer prescribed short-acting bronchodilator (albuterol) immediately and apply supplemental oxygen as needed.
Rationale: Immediate relief of bronchospasm with a bronchodilator and oxygen support is critical to prevent worsening hypoxemia.
A patient with asthma is prescribed both a short-acting bronchodilator (albuterol) and an inhaled corticosteroid (fluticasone). The patient asks, “Why do I have to take two different inhalers?” How should the nurse respond?
“The albuterol works quickly to open your airways when you are short of breath, while the corticosteroid reduces airway inflammation and helps prevent future attacks.”
A hospital identifies repeated medication errors on a ward. As part of Clinical Governance, what nursing-led strategies could be implemented to address this, and how would these strategies reflect the principles of Clinical Governance?
Strategies could include conducting a clinical audit, enhancing staff training, using evidence-based safety checklists, improving reporting and feedback systems, and involving patients in care decisions. These actions reflect quality improvement, risk management, evidence-based practice, and leadership
A nurse manager must respond to a sudden patient emergency involving multiple staff members with different skill levels. Which leadership style would be most effective in this situation and why?
Autocratic leadership would be most effective because it allows rapid decision-making, clear direction, and control in urgent situations where staff input would delay critical action