Nokea
Which of the following instructions should the nurse give a client about his active tuberculosis (TB)?
- A. "It's okay to miss a dose every day or two."
- B. "If side effects occur, stop taking the medication."
- C. "Only take the medication until you feel better."
- D. "You must comply with the medication regimen to treat TB."
Correct Answer: D
Rationale: The correct answer is D because adherence to the medication regimen is crucial in treating active TB to prevent drug resistance and ensure successful treatment. Missing doses can lead to treatment failure and the spread of TB. Option A is incorrect because missing doses compromises treatment effectiveness. Option B is incorrect as stopping medication due to side effects can also result in treatment failure. Option C is incorrect because TB treatment must be completed as prescribed, regardless of symptom improvement.
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The client with sleep apnea has a nursing diagnosis of Sleep Deprivation related to disrupted sleep cycle. Which action should you delegate to the nursing assistant?
- A. Discuss weight loss strategies such as diet and exercise with the client.
- B. Teach client how to apply the BiPAP machine before sleeping.
- C. Remind client to sleep on his side instead of his back.
- D. Administer modafinil (Provigil) to promote daytime wakefulness.
Correct Answer: C
Rationale: The correct answer is C. Reminding the client to sleep on their side is a simple intervention suitable for a nursing assistant. Discussing weight loss strategies (A) and teaching BiPAP machine use (B) require more specialized knowledge. Administering medication (D) is outside the scope of practice for a nursing assistant.
Which of the following signs may be revealed in a client with tonsillar infection by a visual examination if group A streptococci is the cause?
- A. White patches on the tonsils
- B. Hemorrhage in the tonsils
- C. Hypertrophied tonsils
- D. Bleeding in the tonsils
Correct Answer: A
Rationale: The correct answer is A. White patches on the tonsils are characteristic of streptococcal infections, such as strep throat. B (hemorrhage) and D (bleeding) are not typical findings in streptococcal infections. C (hypertrophied tonsils) may occur but is not specific to group A streptococci.
Which of the following serum lab values is a risk factor for the development of atherosclerosis?
- A. LDL 150 mg/dL
- B. Triglycerides 140 mg/dL
- C. Cholesterol 190 mg/dL
- D. HDL 100mg/dL
Correct Answer: A
Rationale: The correct answer is A: LDL 150 mg/dL. LDL cholesterol is known as "bad" cholesterol, and high levels are a risk factor for atherosclerosis. LDL can build up in the arteries, leading to plaque formation and narrowing of blood vessels. Elevated LDL levels increase the risk of cardiovascular disease.
Summary:
B: Triglycerides 140 mg/dL - Elevated triglycerides are a risk factor for heart disease, but not as directly linked to atherosclerosis as LDL.
C: Cholesterol 190 mg/dL - Total cholesterol includes both HDL and LDL, so this value alone does not specify the risk factor for atherosclerosis.
D: HDL 100mg/dL - High levels of HDL are actually considered beneficial as it is known as "good" cholesterol and helps to remove LDL from the bloodstream, reducing the risk of atherosclerosis.
Which of these statements is correct?
- A. Regular bronchioles are the most distal part of the respiratory tract to contain glands.
- B. Larynx do contain significant amounts of smooth muscle
- C. Goblet cells are abundant in the small bronchi and respiratory bronchioles
- D. Elastic fibres are more abundant in the bronchi and bronchioles than the upper respiratory tract.
Correct Answer: D
Rationale: The correct answer is D because elastic fibers are more abundant in the bronchi and bronchioles than the upper respiratory tract. Elastic fibers provide elasticity and recoil to help with airway expansion and contraction during breathing. This is crucial in the bronchi and bronchioles to maintain airflow dynamics.
Choice A is incorrect because regular bronchioles do not contain glands; they are found in the respiratory bronchioles. Choice B is incorrect because larynx contains a significant amount of cartilage, not smooth muscle. Choice C is incorrect because goblet cells are abundant in the larger bronchi, trachea, and bronchioles, not in the small bronchi and respiratory bronchioles.
An older adult is brought to the emergency department by a family member who reports a moderate change in mental status and mild cough. The client is afebrile. The primary health care provider orders a chest x-ray. The family member questions why this is needed since the symptoms seem so vague. What response by the nurse is best?
- A. Chest x-rays are always ordered when we suspect pneumonia.
- B. Older people often have vague symptoms, so an x-ray is essential.
- C. The x-ray can be done and read before laboratory work is reported.
- D. We are testing for any possible source of infection in the client.
Correct Answer: B
Rationale: The correct answer is B because older adults often present with atypical or vague symptoms when they have an underlying infection, including pneumonia. It is crucial to assess for pneumonia in older adults promptly because they may not exhibit classic signs like fever. An x-ray is essential to confirm or rule out pneumonia as it allows for visualization of lung abnormalities.
Choice A is incorrect because not all older adults with vague symptoms automatically have pneumonia, and ordering a chest x-ray is based on clinical judgment. Choice C is incorrect as the timing of the x-ray in relation to laboratory work is not the primary reason for ordering it. Choice D is incorrect because the x-ray is specifically to assess for pneumonia, not for general infection sources.