Nokea
A 62-year-old man is admitted with emphysema and acute upper respiratory infection. Oxygen is ordered at 2 L/min. The reason for low-flow oxygen is to:
- A. prevent excessive drying of secretions.
- B. facilitate oxygen diffusion of the blood.
- C. prevent depression of the respiratory drive.
- D. compensate for increased airway resistance.
Correct Answer: C
Rationale: In COPD, low oxygen levels drive respiration. Low-flow oxygen prevents suppression of the respiratory drive, which could occur with high-flow oxygen.
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Which statement below is incorrect about a deep vein thrombosis (DVT)?
- A. Veins that are most susceptible to a deep vein thrombosis are the peroneal, posterior tibial, popliteal and superficial femoral.
- B. DVTs tend to mostly occur in the lower extremities but can occur in the upper extremities too.
- C. A deep vein thrombosis in the lower extremity has a low probability of becoming a pulmonary embolism.
- D. A DVT is a type of venous thromboembolism (VTE), which is a blood clot that starts in the vein.
Correct Answer: C
Rationale: This option is INCORRECT. All the other statements are true about a DVT. Option C is wrong because it should say: 'A deep vein thrombosis in the lower extremity has a HIGH (not low) probability of becoming a pulmonary embolism.'
Which assessment finding indicates that the client has most likely developed pleurisy as a result of the pneumonia?
- A. Productive cough
- B. Pain when breathing
- C. Cyanotic nail beds
- D. Rapid heart rate
Correct Answer: B
Rationale: Pleurisy causes sharp chest pain during breathing due to inflammation of the pleural membranes.
As the nurse you know that one of the reasons for an increase in multi-drug-resistant tuberculosis is:
- A. Incorrect medication ordered
- B. Increase in tuberculosis cases nationwide
- C. Incorrect route of drug ordered
- D. Noncompliance due to duration of medication treatment needed
Correct Answer: D
Rationale: Noncompliance with TB treatment, often due to the long duration (6-9 months or more), is a major cause of multi-drug-resistant TB, as incomplete treatment allows bacteria to develop resistance.
Which action should the nurse implement for the client with a hemothorax who has a right-sided chest tube with excessive bubbling in the water-seal compartment?
- A. Check the amount of wall suction being applied.
- B. Assess the tubing for blood clots.
- C. Milk the tubing proximal to distal.
- D. Encourage the client to cough forcefully.
Correct Answer: A
Rationale: Excessive bubbling suggests an air leak or high suction; checking suction (A) is first. Clots (B), milking (C), and coughing (D) are secondary or inappropriate.
Which nursing intervention is most important in response to the client's physical symptoms at this time?
- A. Administering oxygen by face mask
- B. Assessing the client's capillary refill
- C. Having the client rate the pain on a pain scale
- D. Requesting a physician's order for cardiac enzymes
Correct Answer: A
Rationale: Administering oxygen addresses hypoxia, a critical concern in pulmonary embolism due to impaired gas exchange.