Nokea
A client with schizophrenia is beginning therapy with clozapine. Which statement indicates a need for further teaching?
- A. I will need to have my blood work checked regularly while taking clozapine.
- B. I understand that clozapine may cause me to gain weight.
- C. I should report any signs of a fever while taking clozapine.
- D. I should discontinue clozapine once my symptoms improve.
Correct Answer: D
Rationale: The correct answer is D because clients should continue taking clozapine even if their symptoms improve. Abruptly discontinuing the medication can lead to relapse. Choices A, B, and C are all correct statements regarding clozapine therapy. Regular blood work monitoring is necessary due to potential side effects, weight gain is a common side effect of clozapine, and reporting signs of fever is important as it can indicate a serious side effect of clozapine.
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A client who has a positive stool culture for Clostridium difficile should be placed in which type of room for infection control purposes?
- A. Wear a face shield prior to entering the room.
- B. Place the client in a private room.
- C. Place the client in a negative pressure room.
- D. Use an alcohol-based hand rub following client care.
Correct Answer: B
Rationale: Placing the client in a private room is the appropriate infection control measure for C. difficile to prevent the spread of infection. While wearing a face shield may be necessary for procedures that generate splashes or sprays, it is not the primary precaution for C. difficile. Negative pressure rooms are typically used for airborne infections, not for C. difficile. Using an alcohol-based hand rub is important for hand hygiene but is not specific to managing C. difficile infection.
A nurse is assessing a client who has chronic obstructive pulmonary disease (COPD). Which of the following findings should the nurse report to the provider?
- A. Oxygen saturation of 91%
- B. Use of pursed-lip breathing
- C. Productive cough with green sputum
- D. Decreased breath sounds in the right lower lobe
Correct Answer: D
Rationale: The correct finding the nurse should report to the provider is decreased breath sounds in the right lower lobe. This can indicate a respiratory infection or atelectasis in clients with COPD, requiring further evaluation and intervention.
Choice A, an oxygen saturation of 91%, although slightly lower than normal, does not necessarily require immediate reporting unless the client's baseline is significantly higher. Choice B, the use of pursed-lip breathing, is actually a beneficial technique for clients with COPD to improve oxygenation and reduce shortness of breath, so it does not need reporting. Choice C, a productive cough with green sputum, can be common in clients with COPD and may indicate an infection, but it is not as concerning as decreased breath sounds in a specific lung lobe which may signify a more acute issue.
How should a healthcare professional prepare a patient for a colonoscopy?
- A. Provide clear instructions on diet
- B. Explain the procedure in detail
- C. Ensure the patient has an empty stomach
- D. Give a bowel prep solution
Correct Answer: D
Rationale: Giving a bowel prep solution is essential to clean out the colon thoroughly before a colonoscopy. This process is crucial as it helps to achieve a clear view of the colon during the procedure. Providing clear instructions on diet (Choice A) and ensuring the patient has an empty stomach (Choice C) are important steps in the preparation process but may not be sufficient on their own to adequately cleanse the colon. Explaining the procedure in detail (Choice B) is helpful for patient education but does not directly contribute to the physical preparation required for a successful colonoscopy.
A nurse is assessing a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?
- A. Barrel-shaped chest
- B. Bradycardia
- C. Increased respiratory rate
- D. Tracheal deviation
Correct Answer: C
Rationale: Corrected Rationale: An increased respiratory rate is a common finding in clients with ARDS as the body attempts to compensate for impaired gas exchange. Barrel-shaped chest (Choice A) is associated with conditions like COPD, not ARDS. Bradycardia (Choice B) is unlikely in ARDS due to the body's compensatory mechanisms to improve oxygenation. Tracheal deviation (Choice D) is not typically seen in ARDS and is more suggestive of other respiratory conditions.
How should a healthcare professional manage a patient with respiratory distress?
- A. Administer bronchodilators
- B. Administer oxygen
- C. Check oxygen saturation
- D. Reposition the patient
Correct Answer: B
Rationale: Administering oxygen is crucial in managing a patient with respiratory distress as it helps improve oxygenation and alleviate breathing difficulties. While administering bronchodilators may be beneficial in certain respiratory conditions like asthma or COPD, in a patient with respiratory distress, ensuring adequate oxygen supply takes precedence. Checking oxygen saturation is important, but the immediate intervention to address respiratory distress is providing supplemental oxygen. Repositioning the patient may be helpful in optimizing ventilation but is not the primary intervention in managing acute respiratory distress.