Nokea
You are providing care to a patient with COPD who is receiving medical treatment for exacerbation. The patient has a history of diabetes, hypertension, and hyperlipidemia. The patient is experiencing extreme hyperglycemia and bruising. Which medication ordered for this patient can cause hyperglycemia and bruising?
- A. Prednisone
- B. Atrovent
- C. Flagyl
- D. Levaquin
Correct Answer: A
Rationale: Prednisone , a corticosteroid, commonly causes hyperglycemia and easy bruising as side effects. Atrovent , Flagyl , and Levaquin are not typically associated with these effects.
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Which task is most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?
- A. Feed a client who is postoperative tonsillectomy the first meal of clear liquids.
- B. Encourage the client diagnosed with a cold to drink a glass of orange juice.
- C. Obtain a throat culture on a client diagnosed with bacterial pharyngitis.
- D. Escort the client diagnosed with laryngitis outside to smoke a cigarette.
Correct Answer: B
Rationale: Encouraging juice intake (B) is within UAP scope and safe. Feeding post-tonsillectomy (A) risks bleeding, throat cultures (C) require training, and smoking (D) is contraindicated.
The ABG analysis results reveal that the client's partial pressure of arterial carbon dioxide (PaCO2) is 65 mm Hg. The nurse recognizes that this is abnormal because normal PaCO2 levels fall between which values?
- A. 7.35 and 7.45
- B. 80 and 100 mm Hg
- C. 35 and 45 mm Hg
- D. 22 and 26 mm Hg
Correct Answer: C
Rationale: Normal PaCO2 levels are 35 to 45 mm Hg; a value of 65 mm Hg indicates hypercapnia, common in COPD.
Which assessment data indicate to the nurse the chest tubes inserted three (3) days ago have been effective in treating the client with a hemothorax?
- A. Gentle bubbling in the suction compartment.
- B. No fluctuation (tidaling) in the water-seal compartment.
- C. The drainage compartment has 250 mL of blood.
- D. The client is able to deep breathe without any pain.
Correct Answer: B
Rationale: No tidaling (B) indicates lung re-expansion, showing effective hemothorax treatment. Bubbling (A) suggests air leak, drainage (C) is expected, and pain-free breathing (D) is secondary.
The nurse and a licensed practical nurse (LPN) are caring for five (5) clients on a medical unit. Which clients would the nurse assign to the LPN? Select all that apply.
- A. The 32-year-old female diagnosed with exercise-induced asthma who has a forced vital capacity of 1,000 mL.
- B. The 45-year-old male with adult-onset asthma who is complaining of difficulty completing all of the ADLs at one time.
- C. The 92-year-old client diagnosed with respiratory difficulty who is beginning to be confused and keeps climbing out of bed.
- D. The 6-year-old client diagnosed with intrinsic asthma who is scheduled for discharge and the mother needs teaching about the medications.
- E. The 20-year-old client diagnosed with asthma who has a pulse oximetry reading of 95% and wants to sleep all the time.
Correct Answer: B,E
Rationale: Stable asthma clients with ADL difficulty (B) and normal SpO2 (E) are suitable for LPN care. Low FVC (A), confusion (C), and discharge teaching (D) require RN assessment.
Before recommending the use of a nonprescription decongestant to a client with a cold, which aspect of the medical history should be assessed? Select all that apply.
- A. Arthritis
- B. Asthma
- C. Hypertension
- D. Diabetes
- E. Glaucoma
- F. Arrhythmias
Correct Answer: C, E, F
Rationale: Decongestants can exacerbate hypertension, glaucoma, and arrhythmias due to their vasoconstrictive effects. Asthma is also a concern as decongestants may worsen respiratory symptoms in some cases.