Nokea
A client with a new tracheostomy is being seen in the oncology clinic. What finding by the nurse best indicates that goals for the client's decrease in self-esteem are being met?
- A. The client demonstrates good understanding of stoma care.
- B. The client has joined a book club that meets at the library.
- C. Family members take turns assisting with stoma care.
- D. Skin around the stoma is intact without signs of infection.
Correct Answer: B
Rationale: The correct answer is B because joining a book club shows an improvement in social engagement and participation, indicating an increase in self-esteem. This choice demonstrates the client's interest in activities outside of their healthcare needs, promoting a sense of normalcy and connection. In contrast, options A, C, and D focus solely on stoma care and physical aspects, not directly related to self-esteem. Understanding stoma care (A) is important but does not address self-esteem directly. Family assistance (C) is supportive but does not necessarily indicate an improvement in the client's self-esteem. Skin integrity (D) is essential for physical health but does not reflect self-esteem.
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Bovine tuberculosis is transmitted from cow to man through
- A. Contact
- B. Milk
- C. Contamination of water with infected urine
- D. Meat
Correct Answer: B
Rationale: The correct answer is A: Contact. Bovine tuberculosis is primarily transmitted through direct contact with infected cows, such as through inhalation of respiratory droplets or consumption of contaminated milk. It is less commonly transmitted through consumption of infected meat or contamination of water with infected urine. Contact with infected animals poses the highest risk for transmission due to the bacterium Mycobacterium bovis being present in respiratory secretions and excretions of infected cows.
A client is in the family practice clinic reporting a severe cold that started 4 days ago. On examination the nurse notes that the client also has a severe headache and muscle aches. What action by the nurse is best?
- A. Educate the client on oseltamivir.
- B. Facilitate admission to the hospital.
- C. Instruct the client to have a flu vaccine.
- D. Teach the client to sneeze in the upper sleeve.
Correct Answer: D
Rationale: The correct answer is D: Teach the client to sneeze in the upper sleeve. This action is best because the client is showing symptoms of a cold, which is typically caused by a virus spread through respiratory droplets. Instructing the client to sneeze in the upper sleeve can help prevent the spread of the virus to others. Choice A is incorrect because oseltamivir is used to treat influenza, not the common cold. Choice B is unnecessary as hospital admission is not typically warranted for a cold. Choice C is also incorrect as the client is already sick and a flu vaccine would not be effective at this point in time.
In general, when looking at acid-base balance, how does the body compensate with metabolic acidosis?
- A. Lungs ""blow off"" CO2 to raise pH
- B. Lungs retain CO2 to lower pH
- C. Kidneys retain more HCO3 to raise the pH
- D. Kidneys excrete more HCO3 to lower pH
Correct Answer: A
Rationale: The correct answer is A. In metabolic acidosis, the lungs compensate by increasing respiratory rate and depth ('blowing off' CO2) to reduce acidity and raise pH. B is incorrect because retaining CO2 would worsen acidosis. C is partially true long-term but slower acting than pulmonary compensation. D is incorrect because excreting bicarbonate lowers pH further.
What type of muscle wraps around a respiratory bronchiole and can change the diameter of the airway?
- A. skeletal muscle
- B. smooth muscle
- C. cardiac muscle
- D. voluntary muscle
Correct Answer: B
Rationale: The correct answer is B: smooth muscle. Smooth muscle is the type of muscle that wraps around a respiratory bronchiole and can contract or relax to change the diameter of the airway. This allows for regulation of airflow in the respiratory system. Skeletal muscle (choice A) is attached to bones and is under voluntary control, not found in the bronchioles. Cardiac muscle (choice C) is specific to the heart and does not control airway diameter. Voluntary muscle (choice D) refers to skeletal muscle, which is not present in the bronchioles and does not regulate airway diameter involuntarily.
The nursing assistant tells you that the client on oxygen at a flow rate of 6 L/min by nasal cannula is complaining of nasal passage discomfort. What intervention should you suggest to improve the client's comfort for this problem?
- A. Suggest that the client's oxygen be humidified.
- B. Suggest that the client be placed on a simple face mask.
- C. Suggest that the client be provided an extra pillow.
- D. Suggest that the client sit up in a chair at the bedside.
Correct Answer: A
Rationale: The correct answer is A. Humidifying oxygen reduces nasal dryness and irritation caused by high-flow oxygen through a nasal cannula. Using a face mask (B) might help but is less practical for long-term use. Providing an extra pillow (C) or sitting up in a chair (D) does not address the nasal discomfort directly.