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A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy. Which instruction should the nurse provide?
- A. Use oxygen continuously, even while sleeping.
- B. Adjust the oxygen flow rate to 5 liters per minute if short of breath.
- C. Report any signs of difficulty breathing immediately.
- D. Take off the oxygen while eating or drinking.
Correct Answer: A
Rationale: The correct answer is A: Use oxygen continuously, even while sleeping. In COPD, maintaining consistent oxygen levels is crucial to prevent hypoxia. Oxygen therapy should be used continuously, including during sleep, to ensure adequate oxygenation. Using oxygen only when short of breath (Choice B) may lead to hypoxia during periods of rest. Reporting difficulty breathing (Choice C) is important but not specific to oxygen therapy. Taking off oxygen while eating or drinking (Choice D) can result in decreased oxygen levels, which can be dangerous for someone with COPD.
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A client with a diagnosis of rheumatoid arthritis is experiencing severe pain. Which medication is likely to be prescribed?
- A. Acetaminophen (Tylenol)
- B. Ibuprofen (Advil)
- C. Methotrexate (Rheumatrex)
- D. Prednisone (Deltasone)
Correct Answer: C
Rationale: The correct answer is C: Methotrexate (Rheumatrex). Methotrexate is a disease-modifying antirheumatic drug commonly prescribed for managing rheumatoid arthritis. It helps reduce inflammation and pain by targeting the immune system's overactivity. Acetaminophen (A) is a mild pain reliever and does not treat the underlying inflammation in rheumatoid arthritis. Ibuprofen (B) is a nonsteroidal anti-inflammatory drug (NSAID) that can help with pain and inflammation but is not as effective in managing rheumatoid arthritis as methotrexate. Prednisone (D) is a corticosteroid that can provide quick relief from inflammation and pain, but it is typically used for short-term management due to its potential side effects.
After a client with ascites due to liver cirrhosis undergoes a paracentesis, what should the nurse do post-procedure?
- A. Encourage the client to drink plenty of fluids
- B. Monitor the client's blood pressure and heart rate
- C. Position the client flat on their back
- D. Administer a dose of furosemide
Correct Answer: B
Rationale: The correct answer is B: Monitor the client's blood pressure and heart rate. Post-paracentesis, there is a risk of hypotension due to sudden fluid shift. Monitoring BP and HR is crucial to detect and manage any hemodynamic changes promptly. Encouraging fluid intake (choice A) may exacerbate ascites. Positioning flat (choice C) may lead to hypotension. Administering furosemide (choice D) without monitoring vital signs can worsen hypotension.
What nursing intervention can help alleviate pruritus in a client with cirrhosis?
- A. Administering antihistamines
- B. Providing a high-protein diet
- C. Applying emollients to the skin
- D. Encouraging frequent baths with hot water
Correct Answer: C
Rationale: The correct answer is C: Applying emollients to the skin. Pruritus is common in cirrhosis due to bile salt accumulation. Emollients help hydrate and protect the skin, reducing itching. Antihistamines (A) may not be effective for pruritus in cirrhosis. High-protein diet (B) is unrelated to pruritus. Hot water baths (D) can worsen itching by drying out the skin.
A 40-year-old man presents with abdominal pain, diarrhea, and weight loss. He has a history of Crohn's disease. Laboratory tests reveal low hemoglobin and elevated ESR. What is the most likely diagnosis?
- A. Ulcerative colitis
- B. Irritable bowel syndrome
- C. Celiac disease
- D. Crohn's disease flare
Correct Answer: D
Rationale: The correct answer is D: Crohn's disease flare. Given the patient's history of Crohn's disease, symptoms of abdominal pain, diarrhea, weight loss, and abnormal lab findings (low hemoglobin, elevated ESR) are indicative of a flare-up of Crohn's disease. This is supported by the clinical presentation and the lab results. Ulcerative colitis (A) presents differently with rectal bleeding and mucous diarrhea. Irritable bowel syndrome (B) does not typically cause weight loss or abnormal lab findings. Celiac disease (C) would present with malabsorption symptoms and specific antibodies, not consistent with this patient's presentation. Crohn's disease flare (D) is the most likely diagnosis based on the information provided.
A client with acute pancreatitis is admitted to the hospital. What is the priority nursing intervention for this client?
- A. Administering oral pancreatic enzymes
- B. Encouraging a high-protein diet
- C. Maintaining NPO status and administering IV fluids
- D. Providing a low-fat diet
Correct Answer: C
Rationale: The priority nursing intervention for a client with acute pancreatitis is maintaining NPO status and administering IV fluids (Choice C). This is because pancreatitis causes inflammation of the pancreas, leading to digestive enzyme release and auto-digestion of pancreatic tissue. By keeping the client NPO, it helps rest the pancreas and decrease enzyme secretion, which can reduce further damage. Administering IV fluids is crucial to maintain hydration and replace lost fluids due to vomiting or decreased oral intake. Choices A, B, and D are incorrect as they focus on dietary interventions such as oral pancreatic enzymes, high-protein, or low-fat diet, which are not appropriate as initial priorities in the acute phase of pancreatitis.