Nokea
A home health nurse is visiting a new client who uses oxygen in the home. For which factors doesn't the nurse assess when determining if the client is using the oxygen safely?
- A. The client does not allow smoking in the house.
- B. Electrical cords are in good working order.
- C. Flammable liquids are stored in the garage.
- D. Household light bulbs are the fluorescent type.
Correct Answer: D
Rationale: The correct answer is D because household light bulbs being fluorescent type is unrelated to the safe use of oxygen. The nurse should assess factors directly related to oxygen safety, such as smoking restrictions, electrical cord condition, and proper storage of flammable materials. Fluorescent light bulbs do not pose a significant risk in relation to oxygen safety.
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One of the following is a difference between pulmonary respiration of frog and human
- A. Diaphragm and ribs play role in respiration
- B. Lungs are respiratory organs
- C. Respiration occurs due to pressure gradient
- D. None of the above
Correct Answer: A
Rationale: The correct answer is A because in frogs, respiration is mainly driven by buccal pumping using their mouth cavity and floor of the mouth, while in humans, diaphragm and ribs play a crucial role in expanding and contracting the chest cavity for breathing. Choices B and C are incorrect as both frogs and humans have lungs as respiratory organs and respiration occurs due to a pressure gradient in both species. Choice D is incorrect as the difference lies in the involvement of the diaphragm and ribs in respiration.
A 17-year-old male is admitted following an automobile accident. He is very anxious, dyspneic, and in severe pain. The left chest wall moves in during inspiration and balloons out when he exhales. The nurse understands these symptoms are most suggestive of?
- A. Hemothorax
- B. Flail chest
- C. Atelectasis
- D. Pleural effusion
Correct Answer: B
Rationale: The correct answer is B: Flail chest. Flail chest is characterized by paradoxical movement of a segment of the chest wall due to multiple rib fractures. In this case, the left chest wall moving in during inspiration and out during expiration indicates this paradoxical movement. This leads to ineffective breathing, causing dyspnea and anxiety. Hemothorax (A) is accumulation of blood in the pleural cavity, not associated with chest wall movement. Atelectasis (C) is collapse of lung tissue, not associated with chest wall movement. Pleural effusion (D) is accumulation of fluid in the pleural space, also not associated with paradoxical chest wall movement.
The collapse of lung is known as:
- A. pleurisy
- B. pleural effusion
- C. atelectasis
- D. pneumothorax
Correct Answer: C
Rationale: The correct answer is C: atelectasis. Atelectasis refers to the collapse of a lung or a part of a lung, leading to incomplete expansion of air sacs. This can be caused by various factors such as blockage of the airways or compression of the lung tissue. Pleurisy (A) is inflammation of the pleura, the lining around the lungs. Pleural effusion (B) is the accumulation of fluid in the pleural space. Pneumothorax (D) is the presence of air in the pleural space, leading to lung collapse. Atelectasis specifically describes the collapse of the lung itself, making it the correct choice.
A sputum study has been ordered for a patient who has developed coarse chest crackles and a fever. At what time should the nurse best collect the sample?
- A. Immediately after a meal
- B. First thing in the morning
- C. At bedtime
- D. After a period of exercise
Correct Answer: B
Rationale: The correct answer is B: First thing in the morning. Sputum should be collected in the morning because it is usually more concentrated, making it easier to obtain a good sample. This is important for accurate analysis and identifying potential pathogens causing the patient's symptoms. Collecting sputum immediately after a meal may result in contamination with food particles. At bedtime, sputum may have accumulated overnight, but morning samples are still preferred due to concentration. Collecting sputum after a period of exercise may introduce respiratory secretions not reflective of the underlying condition.
For which client(s) would you assign the nursing care to the new RN under your supervision? (Choose all that apply.)
- A. A 38-year-old client with moderate persistent asthma awaiting discharge
- B. A 63-year-old client with tracheostomy needing trach care every shift
- C. A 56-year-old client with lung cancer just returned from left lower lobectomy
- D. A 49-year-old new admission client with new diagnosis of esophageal cancer
Correct Answer: D
Rationale: The correct answer includes A and D. Assigning care for clients with moderate persistent asthma (A) and a new diagnosis of esophageal cancer (D) is appropriate for a new RN under supervision. Clients requiring tracheostomy care (B) or post-lobectomy recovery (C) involve complex care unsuitable for a new RN.