Nokea
A client with psoriasis returns to the clinic reporting the persistence of several silvery, scaly areas on the elbows and palms that frequently burn and sometimes bleed. Which prescription should the nurse teach the client to use for the skin condition?
- A. Topical antifungal.
- B. Topical corticosteroids.
- C. Topical analgesics.
- D. Colloidal oatmeal based lotion.
Correct Answer: B
Rationale: Topical corticosteroids are commonly used to reduce inflammation and itching associated with psoriasis, controlling symptoms and promoting healing.
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History and Physical Nurses' Notes
A 34-year-old male client presents to the emergency department (ED) for an acute asthma attack which began after jogging through a local park. The client is able to answer questions, pausing every few words to catch his breath. The client reports using a rescue Inhaler three times, but he just couldn't catch his breath. The client reports that symptoms seem worse when outdoors and when exercising and that episodes like this make him extremely nervous. The client reports that it has been a couple of months since he had an asthma attack, and he came to the ED today because he noticed that his inhaler was expired and was worried the medication was not working.
Initial Assessment
Temperature 98.9° F (37.1° C)
Heart rate 112 beats/minute
Respirations 28 breaths/minute
Blood pressure 130/86 mm Hg
Oxygen saturation 88% on room air
Lung sounds reveal expiratory wheezes
Capillary refill time 2 seconds
Orders
Administer albuterol 2.5 mg/ipratropium bromide 0.5 mg in 3 mL solution via nebulizer four times a day and PRN.
Administer prednisone 60 mg PO
Administer oxygen to keep oxygen saturation greater than 94%, titrate as needed.
The nurse has implemented additional needed actions. Click the assessment data which indicates the interventions were successful and which assessment data provides no indication that the interventions were successful.
- A. Decrease in heart rate from 112 to 105 beats per minute.
- B. Client able to speak in full sentences without pausing.
- C. Clear lung sounds.
- D. Reduction in respiratory rate to 16 breaths per minute.
- E. Client reports breathing is eased.
- F. Blood pressure within normal limits.
Correct Answer: A,B,C,D,E,F
Rationale: The assessment data showing decreased heart rate, ability to speak in full sentences, clear lung sounds, reduced respiratory rate, eased breathing, and stable blood pressure all indicate successful interventions for the asthma attack.
The nurse is caring for a client that is unconscious and having seizures. Which nursing intervention is most essential in this client's plan of care?
- A. Ensure oral suction is available.
- B. Provide frequent mouth care.
- C. Keep the room at a comfortable temperature.
- D. Maintain the client in a semi-Fowler's position.
Correct Answer: A
Rationale: Ensuring oral suction is available is the most essential intervention to maintain a clear airway and prevent aspiration during and after seizures, particularly in an unconscious client.
The nurse is providing teaching to a client about self-management of type 2 diabetes mellitus. Which information provided by the client indicates understanding?
- A. Using salt, herbs, and spices will improve the flavor of foods.
- B. Restrict alcoholic beverages to no more than 1-2 per week.
- C. Eat a protein snack 30 minutes before any exercise workout.
- D. Get an influenza vaccine every year as soon as available.
Correct Answer: D
Rationale: Getting an influenza vaccine every year is a crucial aspect of diabetes self-management, as people with diabetes are at increased risk of complications from influenza.
The nurse assists a client with Parkinson's disease to ambulate in the hallway. The client appears to 'freeze' and then carefully lifts one leg and steps forward. The client tells the nurse of pretending to step over a crack on the floor. How should the nurse respond?
- A. Plan to assess the client's cognition after returning to the room.
- B. Confirm that this is an effective technique to help with ambulation.
- C. Assist the client to a carpeted area to walk more easily.
- D. Reorient the client to the present location and circumstances.
Correct Answer: B
Rationale: Confirming that the client's technique of pretending to step over a crack is an effective strategy acknowledges the client's self-initiated coping mechanism for freezing episodes, which can help promote independence in ambulation.
A client is admitted to the medical unit during an exacerbation of systemic lupus erythematosus (SLE). It is most important for the nurse to report which assessment finding to the healthcare provider?
- A. Muscle atrophy.
- B. Low grade fever.
- C. Joint pain.
- D. Hematuria.
Correct Answer: D
Rationale: Hematuria can indicate lupus nephritis, a serious complication of SLE. Prompt reporting to the healthcare provider is crucial for appropriate management and prevention of further kidney damage.