Nokea
A client with a history of asthma and bronchitis arrives at the clinic with shortness of breath, productive cough with thickened tenacious mucous, and the inability to walk up a flight of stairs without experiencing breathlessness. Which action is most important for the nurse to instruct the client about self-care?
- A. Increase the daily intake of oral fluids to liquefy secretions
- B. Avoid crowded enclosed areas to reduce pathogen exposure
- C. Call the clinic if undesirable side effects of mediations occur
- D. Teach anxiety reduction methods for feelings of suffocation
Correct Answer: A
Rationale: Increasing fluid intake helps to thin secretions, making them easier to expectorate and improving airway clearance.
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The following statements concerning acute gastroenteritis in childhood are correct:
- A. Intravenous fluid therapy is essential in severe cases
- B. Loperamide should be avoided
- C. The commonest causes of failure to thrive following an attack is persistent bacterial infection
- D. Septicaemia is a recognised feature of Salmonella gastroenteritis
Correct Answer: A
Rationale: Intravenous fluid therapy is critical in severe dehydration due to gastroenteritis. Loperamide is contraindicated in children due to risk of serious side effects. Persistent bacterial infection is not the commonest cause of failure to thrive, and septicaemia is rare in Salmonella gastroenteritis.
Varying intensity of the first heart sound from a booming (bruit de canon) to virtual inaudibility is seen in which of the following?
- A. Mitral stenosis with atrial fibrillation
- B. Constant 2:1 AV block
- C. First-degree AV block
- D. Congenital complete heart block
Correct Answer: A
Rationale: In mitral stenosis with atrial fibrillation, the intensity of the first heart sound can vary depending on the dynamics of atrial contraction and ventricular filling.
Ten hours following thrombolysis for an ST elevation myocardial infarction (STEMI), a client is receiving a lidocaine infusion for isolated runs of ventricular tachycardia (VT). Which finding should the nurse document in the electronic medical record as a therapeutic response to the lidocaine infusion?
- A. Stabilization of blood pressure ranges
- B. Cessation of chest pain
- C. Reduce heart rate
- D. Decreased frequency of episodes of VT
Correct Answer: D
Rationale: Lidocaine is used to suppress ventricular tachycardia, so a decrease in episodes indicates a therapeutic response.
Psychosis in children is suggested by:
- A. Absence of speech
- B. Intense outbursts of temper
- C. Recurrence of bed-wetting following a period of control
- D. Feelings of depersonalisation
Correct Answer: D
Rationale: Feelings of depersonalisation are a hallmark of psychosis. Absence of speech and temper outbursts are nonspecific, and bed-wetting is not diagnostic.
Causes of non-bloody diarrhoea include:
- A. Shigella dysentery
- B. Campylobacter jejuni
- C. Giardia lamblia
- D. Salmonella
Correct Answer: C
Rationale: Giardia lamblia is a common cause of non-bloody diarrhoea. Shigella and Campylobacter typically cause bloody diarrhoea.