Nokea
A client is prescribed nicotine replacement therapy. Which statement should the nurse include in this client's teaching?
- A. Smoking while taking this medication will increase your risk of a stroke.
- B. Make a list of reasons why smoking is a bad habit.
- C. Stopping this medication suddenly increases your risk for a heart attack.
- D. Rise slowly when getting out of bed in the morning.
Correct Answer: A
Rationale: The correct answer is A because smoking while on nicotine replacement therapy can lead to nicotine overdose, increasing the risk of a stroke due to excessive nicotine intake. This statement emphasizes the importance of avoiding smoking during treatment.
Choice B is incorrect as it does not address the specific risk associated with smoking while on the medication. Choice C is incorrect as stopping the medication suddenly does not directly increase the risk for a heart attack. Choice D is irrelevant to nicotine replacement therapy and does not provide information related to the medication's use.
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While discussing factors causing emphysema with Mr. Puff, what major factor is he already aware of?
- A. Air pollution
- B. Repeated bronchial infections
- C. Cigarette smoking
- D. Hereditary
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client with a pleural effusion is being assessed by a nurse. Which clinical manifestation does the nurse expect to find?
- A. Decreased breath sounds on the affected side
- B. Hyperresonance on percussion of the affected side
- C. Increased tactile fremitus on the affected side
- D. Tracheal deviation toward the affected side
Correct Answer: A
Rationale: The correct answer is A: Decreased breath sounds on the affected side. In a pleural effusion, fluid accumulates in the pleural space, leading to decreased air entry and diminished breath sounds on auscultation. This occurs because the fluid dampens the transmission of sound through the lungs.
B: Hyperresonance on percussion of the affected side is not expected in pleural effusion, as it is typically associated with conditions like pneumothorax.
C: Increased tactile fremitus on the affected side is not a typical finding in pleural effusion. Tactile fremitus may be decreased due to the presence of fluid.
D: Tracheal deviation toward the affected side is more commonly seen in conditions like tension pneumothorax, not pleural effusion.
A deathly ill patient from a culture different than the nurse’s is admitted. Which question is appropriate to help the nurse provide culturally competent care?
- A. “If you die
- B. will you want an autopsy?”
- C. “Are you interested in learning about palliative or hospice care?”
- D. “Do you have any preferences for what happens if you are dying?”
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
While assessing a client with a tracheostomy, a nurse notes that the tracheostomy tube is pulsing with the heartbeat during a pulse check. No other abnormal findings are noted. What action should the nurse take?
- A. Notify the operating room of a potential emergency case.
- B. No action is required at this time; this pulsation can be a normal finding in some clients.
- C. Remove the tracheostomy tube and ventilate the client using a bag-valve-mask.
- D. Stay with the client and ask someone else to contact the provider immediately.
Correct Answer: D
Rationale: The correct answer is D: Stay with the client and ask someone else to contact the provider immediately.
Rationale:
1. Pulsation of the tracheostomy tube with heartbeat indicates the tube is very close to a major blood vessel.
2. Immediate provider notification is crucial to prevent potential complications.
3. Removing the tube without professional guidance can lead to severe bleeding and airway compromise.
4. Contacting the provider promptly ensures timely intervention and appropriate next steps.
Summary:
A: Notifying the operating room is premature and unnecessary at this point.
B: Pulsation may not always be normal and warrants immediate action.
C: Removing the tube without professional guidance can be harmful to the client.
A client with chronic obstructive pulmonary disease (COPD) is being assessed by a nurse. Which finding does the nurse expect?
- A. Increased anteroposterior (AP) chest diameter
- B. Decreased respiratory rate
- C. Weight gain
- D. Productive cough with yellow sputum
Correct Answer: A
Rationale: The correct answer is A: Increased anteroposterior (AP) chest diameter. In COPD, the chronic obstruction of airflow leads to air trapping in the lungs, causing the chest to expand more front-to-back (increased AP diameter). This is known as "barrel chest" and is a characteristic finding in COPD due to hyperinflation of the lungs.
Incorrect choices:
B: Decreased respiratory rate is not expected in COPD as patients may have increased respiratory rate due to difficulty breathing.
C: Weight gain is not a typical finding in COPD as patients often experience weight loss due to increased energy expenditure and decreased appetite.
D: Productive cough with yellow sputum is common in COPD, but it is not the most specific finding for this condition.