Nokea
A patient taking Isoniazid (INH) should be monitored for what deficiency?
- A. Vitamin C
- B. Calcium
- C. Vitamin B6
- D. Potassium
Correct Answer: C
Rationale: Isoniazid can cause peripheral neuropathy due to vitamin B6 (pyridoxine) deficiency. Patients are often given B6 supplements and monitored for this deficiency.
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Select all the correct options that represent the pathophysiology of an asthma attack.
- A. The smooth muscle surrounding the alveoli constricts, limiting oxygenation.
- B. The mucosa lining experiences severe inflammation.
- C. The goblet cells within the mucosa lining produce excessive amounts of mucous.
- D. Too much carbon dioxide is exhaled due to hyperventilation and the patient experiences respiratory alkalosis.
Correct Answer: B,C
Rationale: Asthma involves inflammation of the airway mucosa and excessive mucus production by goblet cells. Smooth muscle constriction occurs in bronchioles, not alveoli, and hyperventilation typically leads to respiratory acidosis due to CO2 retention.
The nurse is caring for a client diagnosed with pneumonia who is having shortness of breath and difficulty breathing. Which intervention should the nurse implement first?
- A. Take the client's vital signs.
- B. Check the client's pulse oximeter reading.
- C. Administer oxygen via nasal cannula.
- D. Notify the respiratory therapist STAT.
Correct Answer: C
Rationale: Administering oxygen (C) is the first intervention for a pneumonia patient with shortness of breath to correct hypoxemia, per the ABCs (airway, breathing, circulation). Checking pulse oximetry (B) assesses oxygenation but delays treatment. Vital signs (A) and notifying the therapist (D) are secondary to immediate oxygen delivery.
As the nurse you know that one of the reasons for an increase in multi-drug-resistant tuberculosis is:
- A. Incorrect medication ordered
- B. Increase in tuberculosis cases nationwide
- C. Incorrect route of drug ordered
- D. Noncompliance due to duration of medication treatment needed
Correct Answer: D
Rationale: Noncompliance with TB treatment, often due to the long duration (6-9 months or more), is a major cause of multi-drug-resistant TB, as incomplete treatment allows bacteria to develop resistance.
The nurse and an unlicensed assistive personnel (UAP) are caring for an elderly client diagnosed with emphysema. Which nursing tasks could be delegated to the UAP to improve gas exchange? Select all that apply.
- A. Keep the head of the bed elevated.
- B. Encourage deep breathing exercises.
- C. Record pulse oximeter reading.
- D. Assess level of consciousness.
- E. Auscultate breath sounds.
Correct Answer: A,C
Rationale: UAPs can keep the head of the bed elevated (1) to improve lung expansion and record pulse oximetry (3), a non-invasive task. Encouraging deep breathing (2) requires teaching, a nursing role. Assessing consciousness (4) and auscultating breath sounds (5) are assessment tasks reserved for nurses.
The physician orders an acid-fast bacilli sputum culture smear on a patient with possible tuberculosis. How will you collect this?
- A. Collect 2 different sputum specimens 12 hours apart
- B. Collect 3 different sputum specimens (one in the morning, afternoon, and at night)
- C. Collect 3 different sputum specimens on 3 different days
- D. Collect 2 different sputum specimens on 2 different days
Correct Answer: C
Rationale: This is how an AFB sputum culture is collected.