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A client with chronic obstructive pulmonary disease (COPD) is prescribed long-term oxygen therapy. What is the most important nursing consideration for this client?
- A. Assessing for signs of oxygen toxicity
- B. Monitoring the client's carbon dioxide levels
- C. Promoting proper humidification of oxygen
- D. Ensuring an adequate supply of oxygen
Correct Answer: B
Rationale: Monitoring carbon dioxide levels (B) is critical in COPD clients on long-term oxygen therapy, as they may retain CO2, risking respiratory acidosis if oxygen suppresses their hypoxic drive (target SpO2 88-92%). Oxygen toxicity (A) is rare at low flows used in COPD. Humidification (C) enhances comfort but isn't the priority. Oxygen supply (D) is a general need, not COPD-specific. CO2 monitoring via ABGs or capnography ensures safe titration, preventing hypercapnia, a key consideration per COPD management guidelines like GOLD standards.
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All of the following can cause tachycardia except:
- A. Fever
- B. Exercise
- C. Sympathetic nervous system stimulation
- D. Parasympathetic nervous system stimulation
Correct Answer: D
Rationale: Parasympathetic stimulation slows heart rate; others increase it.
Which of the following is more life threatening?
- A. BP=180/100
- B. BP=160/120
- C. BP=90/60
- D. BP=80/50
Correct Answer: D
Rationale: BP 80/50 is most life-threatening e.g., hypoperfusion risks failure vs. 180/100 (hypertension), 160/120 (severe), 90/60 (borderline). Nurses prioritize this e.g., fluids for stability, per hemodynamics.
A nurse identifies ways he/she can improve performance. He/she reflects on his nursing experiences. This is an example of the core critical thinking skill:
- A. Self-regulation
- B. Analysis
- C. Inference
- D. Explanation
Correct Answer: A
Rationale: Self-regulation in critical thinking involves monitoring and improving one's performance through reflection on experiences, identifying strengths and weaknesses. A nurse reflecting on past care to enhance future practice exemplifies this e.g., adjusting communication after a patient misunderstanding. Analysis breaks down data (e.g., lab results), not necessarily reflecting on personal performance. Inference draws conclusions from evidence (e.g., diagnosing from symptoms), not self-improvement. Explanation justifies actions (e.g., why a drug was given), not introspective growth. Self-regulation's focus on self-assessment and correction aligns with the nurse's reflective process, fostering continuous professional development, a vital skill in nursing for adapting to challenges and ensuring high-quality, patient-centered care over time.
The nurse working in the community is assigned to the care of several clients. Which client(s) may require assistance to overcome barriers to accessing adequate care?
- A. A student entering a local university
- B. A client who is a migrant and works on a farm
- C. An older adult client living independently
- D. A client who has been unemployed for 6 months
Correct Answer: B
Rationale: Barriers to healthcare access often hit vulnerable groups hardest, requiring nursing intervention. A migrant farm worker faces language, mobility, and economic hurdles, limiting care access e.g., no insurance or transport. An older adult living alone may struggle with mobility, health literacy, or isolation, delaying treatment. An unemployed client, lacking income or coverage, often skips care due to cost, risking worsening conditions. A student entering university or an employed pregnant client typically has fewer systemic barriers students may access campus health, employed clients insurance. Nursing must target the migrant, elderly, and jobless, addressing disparities poverty, age, ethnicity ensuring equitable care. This reflects nursing's equity mission, bridging gaps for those society sidelines, enhancing health outcomes through advocacy and resource linkage.
How should the nurse prepare an injection for a patient who takes both regular and NPH insulin?
- A. Draw up the NPH insulin, then the regular insulin, in the same syringe
- B. Draw up the regular insulin, then the NPH insulin, in the same syringe
- C. Use two separate syringes
- D. Check with the physician
Correct Answer: B
Rationale: Regular (clear) is drawn first, then NPH (cloudy), to avoid contamination.