Nokea
The term 'blue bloaters' is used to describe patients with?
- A. Pulmonary hypertension
- B. Left-sided heart failure
- C. Chronic Bronchitis
- D. Emphysema
Correct Answer: C
Rationale: Blue bloaters' describes chronic bronchitis patients, who present with cyanosis ('blue') and edema ('bloating') due to hypoxemia and right heart failure. Emphysema patients are often called 'pink puffers.'
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The nurse is assessing a 79-year-old client diagnosed with pneumonia. Which signs and symptoms should the nurse expect to assess in the client?
- A. Confusion and lethargy.
- B. High fever and chills.
- C. Frothy sputum and edema.
- D. Bradypnea and jugular vein distention.
Correct Answer: A
Rationale: Elderly pneumonia patients often present with confusion/lethargy (A) due to hypoxia. Fever/chills (B) are less common in the elderly, frothy sputum/edema (C) suggest heart failure, and bradypnea/JVD (D) are unrelated.
The nurse is caring for the client diagnosed with bacterial pneumonia. Which priority intervention should the nurse implement?
- A. Assess respiratory rate and depth.
- B. Provide for adequate rest period.
- C. Administer oxygen as prescribed.
- D. Teach slow abdominal breathing.
Correct Answer: C
Rationale: Administering oxygen as prescribed (C) is the priority for bacterial pneumonia to address hypoxemia, a common issue due to impaired gas exchange. Assessing respiratory rate (A) is important but secondary to ensuring oxygenation. Rest (B) and breathing techniques (D) support recovery but are not the first priority.
The client is four (4) hours post-lobectomy for cancer of the lung. Which assessment data warrant immediate intervention by the nurse?
- A. The client has an intake of 1,500 mL IV and an output of 1,000 mL.
- B. The client has 450 mL of bright-red drainage in the chest tube.
- C. The client is complaining of pain at a '10' on a 1-to-10 scale.
- D. The client has absent lung sounds on the side of the surgery.
Correct Answer: B
Rationale: 450 mL bright-red drainage (B) suggests hemorrhage, requiring immediate action. Fluid balance (A), severe pain (C), and absent lung sounds (D) are expected or less urgent.
Which specimen collection technique should the nurse use to correctly obtain the throat culture from the client?
- A. The nurse asks the client to expectorate sputum into a paper cup.
- B. The nurse wipes the inner mouth and tongue with gauze.
- C. The nurse swabs the throat with a sterile cotton applicator.
- D. The nurse collects saliva in a sterile culture cup.
Correct Answer: C
Rationale: A throat culture requires swabbing the pharynx with a sterile cotton applicator to collect a sample from the area most likely to harbor pathogens.
Which priority intervention should the nurse implement for the client diagnosed with coal workers' pneumoconiosis?
- A. Monitor the client's intake and output.
- B. Assess for black-streaked sputum.
- C. Monitor the white blood cell count daily.
- D. Assess the client's activity level every shift.
Correct Answer: B
Rationale: Black-streaked sputum (B) is a hallmark of coal workers' pneumoconiosis due to coal dust deposition, making its assessment a priority to confirm disease impact. Intake/output (A) is non-specific. Daily WBC counts (C) are unnecessary unless infection is suspected. Activity level (D) is secondary to symptom assessment.