Nokea
A client with emphysema has been receiving oxygen at 3 L per minute by nasal cannula. The nurse knows that the goal of the client's oxygen therapy is achieved when the client's PaO2 reading is:
- A. 50-60 mm Hg
- B. 70-80 mm Hg
- C. 80-90 mm Hg
- D. 90-98 mm Hg
Correct Answer: B
Rationale: For clients with emphysema, a PaO2 of 70-80 mm Hg indicates adequate oxygenation without suppressing the respiratory drive.
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The doctor has prescribed Claratin (loratidine) for a client with seasonal allergies. The feature that separates Claratin from other antihistamines such as diphenhydramine is that the medication:
- A. Is nonsedating
- B. Stimulates appetite
- C. Is used for motion sickness
- D. Is less expensive
Correct Answer: A
Rationale: Loratadine (Claritin) is a second-generation antihistamine that is nonsedating, unlike first-generation antihistamines like diphenhydramine.
The physician has discussed the need for medication with the parents of an infant with congenital hypothyroidism. The nurse can reinforce the physician's teaching by telling the parents that:
- A. The medication will be needed only during times of rapid growth.
- B. The medication will be needed throughout the child's lifetime.
- C. The medication schedule can be arranged to allow for drug holidays.
- D. The medication is given one time daily every other day.
Correct Answer: B
Rationale: Congenital hypothyroidism requires lifelong thyroid hormone replacement therapy to maintain normal metabolism and development.
A client with AIDS asks the nurse why he cannot have a pitcher of water left at his bedside. The nurse should tell the client that:
- A. It would be best for him to drink ice water.
- B. He should drink several glasses of juice instead.
- C. It makes it easier to keep a record of his intake.
- D. He should drink only freshly run water.
Correct Answer: D
Rationale: For clients with AIDS, stagnant water in a pitcher can harbor bacteria, posing an infection risk due to their compromised immune system. Freshly run water minimizes this risk.
The RN is planning client assignments. Which is the least appropriate task for the nursing assistant?
- A. Assisting a COPD client admitted 2 days ago to get up in the chair
- B. Feeding a client with bronchitis who is paralyzed on the right side
- C. Accompanying a discharged emphysema client to the transportation area
- D. Assessing an emphysema client complaining of difficulty breathing
Correct Answer: D
Rationale: Assessment of breathing difficulty requires RN expertise to evaluate and intervene, making it inappropriate for a nursing assistant.
A client with cirrhosis has developed signs of heptorenal syndrome. Which diet is most appropriate for the client at this time?
- A. High protein, moderate sodium
- B. High carbohydrate, moderate sodium
- C. Low protein, low sodium
- D. Low carbohydrate, high protein
Correct Answer: C
Rationale: Low protein and low sodium diets reduce the burden on the liver and kidneys in hepatorenal syndrome.