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A patient is taking Streptomycin. Which finding below requires the nurse to notify the physician?
- A. Patient reports a change in vision.
- B. Patient reports a metallic taste in the mouth.
- C. The patient has ringing in their ears.
- D. The patient has a persistent dry cough.
Correct Answer: C
Rationale: This medication can be very toxic to the ears (cranial nerve 8). Therefore, it is alarming if the patient reports ringing in their ears, which could represent ototoxicity.
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Which response by the nurse is most appropriate at this time?
- A. The pain will lessen in a few minutes.
- B. I will stay with you until the physician comes.
- C. Why would you even think something like that?
- D. Are your financial affairs in order?
Correct Answer: B
Rationale: Staying with the client provides emotional support and ensures prompt intervention during a suspected pulmonary embolism.
The client diagnosed with ARDS is transferred to the intensive care department and placed on a ventilator. Which intervention should the nurse implement first?
- A. Confirm that the ventilator settings are correct.
- B. Verify that the ventilator alarms are functioning properly.
- C. Assess the respiratory status and pulse oximeter reading.
- D. Monitor the client's arterial blood gas results.
Correct Answer: C
Rationale: Assessing respiratory status and SpO2 (C) ensures immediate patient stability. Ventilator settings (A), alarms (B), and ABGs (D) follow.
Which question is essential for the nurse to ask before administering the influenza vaccine?
- A. Have you had influenza in the last year?
- B. Did you receive pneumonia vaccine last year?
- C. Are you allergic to eggs or egg products?
- D. Do you have a history of respiratory disease?
Correct Answer: C
Rationale: Influenza vaccines are often produced using eggs, so an egg allergy must be assessed to prevent allergic reactions.
The nurse is taking the social history from a client diagnosed with small cell carcinoma of the lung. Which information is significant for this disease?
- A. The client worked with asbestos for a short time many years ago.
- B. The client has no family history for this type of lung cancer.
- C. The client has numerous tattoos covering both upper and lower arms.
- D. The client has smoked two (2) packs of cigarettes a day for 20 years.
Correct Answer: D
Rationale: Smoking (D) (40 pack-years) is the primary risk factor for small cell lung cancer. Asbestos (A) is a risk but less significant, family history (B) is irrelevant, and tattoos (C) are unrelated.
Which action is most appropriate for the nurse to take before the bronchoscopy?
- A. Keep the client NPO for at least 6 hours.
- B. Have the client cough several times.
- C. Ensure that the client gets adequate sleep.
- D. Scrub the client's upper chest with an antiseptic.
Correct Answer: A
Rationale: Keeping the client NPO for at least 6 hours prevents aspiration during bronchoscopy, which involves sedation.