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A nurse criticizes the attending physician and suggests that a different physician should care for the patient. What is your best response?
- A. Call the nurse away from the patient and remind him that the patient can still hear even if unconscious.
- B. Report the nurse to the attending physician.
- C. Ask the nurse why he has such feelings.
- D. Simply nod your head in agreement.
Correct Answer: A
Rationale: Protecting the patient's dignity and ensuring professionalism is paramount.
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When determining hearing acuity, if the client reports first perceiving sound at ___ dB, then his or her hearing is normal.
- A. 4
- B. 8
- C. 12
- D. 16
Correct Answer: A
Rationale: Normal hearing acuity is typically defined as perceiving sound at 0-25 dB. Therefore, 4 dB would be within the range of normal hearing.
What should the nurse instruct Mr. Ross to withhold food and fluid for several hours until after fiberoptic bronchoscopy?
- A. Sputum returns to normal color and consistency
- B. Speech returns to the normal pattern
- C. Vital signs become stable
- D. Cough reflex is present
Correct Answer: D
Rationale: A functioning cough reflex prevents aspiration.
A nurse is assessing a client with a history of seizures. Which assessment finding requires immediate intervention?
- A. The client is experiencing an aura.
- B. The client's antiseizure medication level is within the therapeutic range.
- C. The client has been seizure-free for 2 years.
- D. The client's seizure activity lasts longer than 5 minutes.
Correct Answer: D
Rationale: The correct answer is D because prolonged seizures lasting longer than 5 minutes can lead to status epilepticus, a medical emergency that can cause brain damage or even death. Immediate intervention is necessary to stop the seizure activity. Auras (A) are warning signs of an impending seizure and do not require immediate intervention. Antiseizure medication within therapeutic range (B) indicates proper management. Being seizure-free for 2 years (C) is a positive outcome but does not require immediate intervention unless a seizure occurs.
Place the events below in the order they occur in the patient with obstructive sleep apnea (beginning with 1).
- A. Sleep just before going to work
- B. Narrowing of air passages with muscle relaxation during sleep
- C. Apnea lasting 10 to 90 seconds
- D. Brief arousal and airway opened
Correct Answer: C
Rationale: The correct order is E (narrowing), A (apnea), C (arousal). Muscle relaxation leads to airway narrowing, followed by apnea and then arousal.
A client with chronic obstructive pulmonary disease (COPD) who has been receiving oxygen therapy at 2 L/min now has a respiratory rate of 10 breaths/min. What action should the nurse take first?
- A. Increase the oxygen flow rate to 4 L/min.
- B. Administer a bronchodilator via nebulizer.
- C. Encourage the client to take deep breaths.
- D. Assess the client's mental status and level of consciousness.
Correct Answer: D
Rationale: The correct answer is D, assessing the client's mental status and level of consciousness. This is the first action to take because a respiratory rate of 10 breaths/min in a COPD client receiving oxygen therapy may indicate respiratory depression or impending respiratory failure. Assessing mental status and level of consciousness can help determine if the client is experiencing hypoxia. Increasing oxygen flow rate (A) without assessing the client first can be dangerous if the client is retaining carbon dioxide. Administering a bronchodilator (B) may not address the underlying issue of respiratory depression. Encouraging deep breaths (C) may not be appropriate if the client is in respiratory distress.