Nokea
A client with allergic rhinitis is instructed on the correct technique for using an intranasal inhaler. Which the patient is the client should demonstrate to the nurse that the client understands the instructions?
- A. I should limit the use of the inhaler to early morning and bedtime use.
- B. It is important to not shake the canister because that can damage the spray device.
- C. I should hold one nostril closed while I insert the spray into the other nostril.
- D. The inhaler tip is inserted into the nostril and pointed toward the inside nostril wall.
Correct Answer: C
Rationale: Holding one nostril closed while spraying into the other ensures proper delivery of the medication to the nasal mucosa. Limiting use to specific times is not typically required unless specified by the prescriber. Shaking the canister is often necessary for some inhalers to mix the medication. Pointing the inhaler toward the inner nostril wall is incorrect; it should be directed upward and slightly outward.
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A client with Ménière'sdisease continues to have disabling attacks of vertigo and elects to have a labyrinthectomy. A priority nursing diagnosis for the client before surgery is:
- A. Deficient diversional activity related to inability to participate secondary to vertigo.
- B. Risk for injury related to vertigo.
- C. Powerlessness related to inability to influence effects of disease process.
- D. Social isolation related to hearing loss.
Correct Answer: B
Rationale: Risk for injury related to vertigo is the priority due to the high risk of falls and accidents during vertigo attacks, which is a significant concern pre-surgery.
A 52-year-old client with lung cancer tells the nurse that he has a low-grade fever (100.6°F [38.1°C]), nonproductive cough, and increasing fatigue. He completed the radiation therapy to the mass in his right lung and mediastinum 10 weeks ago and has a follow-up appointment to see the physician in 2 weeks. What is the most appropriate response by the nurse?
- A. Advise the client to take two acetaminophen tablets every 4 to 6 hours for 2 days and call back if his temperature increases to 101°F (38.3°C) or greater.
- B. Advise the client that this is an expected side effect of the radiation therapy and to keep his appointment in 2 weeks.
- C. Advise the client to come to the office to be examined today.
- D. Advise the client to go to the nearest emergency department.
Correct Answer: C
Rationale: Fever, cough, and fatigue post-radiation may indicate infection or pneumonitis, requiring prompt evaluation, especially in a lung cancer patient, so an office visit today is appropriate.
Which of the following goals is a priority for a client who has undergone surgery for retinal detachment?
- A. Control pain.
- B. Prevent an increase in intraocular pressure.
- C. Follow a low-sodium diet.
- D. Maintain a darkened environment.
Correct Answer: B
Rationale: Preventing an increase in intraocular pressure is the priority to protect the surgical repair and prevent complications like re-detachment or hemorrhage.
Which of the following physical assessment findings are normal for a client with advanced chronic obstructive pulmonary disease (COPD)?
- A. Increased anteroposterior chest diameter.
- B. Underdeveloped neck muscles.
- C. Collapsed neck veins.
- D. Increased chest excursions with respiration.
Correct Answer: A
Rationale: Advanced COPD causes air trapping, increasing anteroposterior chest diameter (barrel chest). Neck muscles may hypertrophy from respiratory effort. Neck veins may distend, and chest excursions decrease due to lung hyperinflation.
The nurse is caring for a client reporting an abrupt onset of severe pain associated with metastatic cancer. Which prescription should the nurse plan to administer?
- A. fentanyl via transdermal patch
- B. pregabalin
- C. ketorolac
- D. hydromorphone
Correct Answer: D
Rationale: Hydromorphone is appropriate for rapid relief of severe, acute cancer pain due to its fast-acting opioid properties.