Nokea
A patient with a history of asthma is scheduled for an appendectomy. Because of her asthma, you would include as part of the preoperative teaching the need to perform postoperatively
- A. Coughing and deep breathing exercises.
- B. Leg exercises.
- C. Wound dressing changes.
- D. All of these.
Correct Answer: A
Rationale: Deep breathing exercises help prevent postoperative complications in asthmatic patients.
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A nurse manager wishes to ensure that the nurses on the unit are practicing at their highest levels of competency. Which areas should the manager assess to determine if the nursing staff demonstrate competency according to the Institute of Medicine (IOM) report Health Professions Education: A Bridge to Quality? (Select ONE that does not apply)
- A. Collaborating with an interdisciplinary team
- B. Implementing evidence-based care
- C. Providing family-focused care
- D. Experimenting on patients
Correct Answer: D
Rationale: The correct answer is D: Experimenting on patients. The IOM report emphasizes the importance of evidence-based practice, collaboration, and patient-centered care to ensure nurses are practicing at their highest levels of competency. Experimenting on patients is unethical and not a part of competent nursing practice. Nurses should rely on established evidence and best practices rather than experimenting on patients. Assessing nurses' competency in collaborating with teams, implementing evidence-based care, and providing family-focused care aligns with the IOM's recommendations for quality nursing practice.
The nurse knows that a patient taught sleep hygiene practices needs further instruction when he says
- A. Once I go to bed, I should get up if I am not asleep after 20 minutes.
- B. It’s okay to have my usual two glasses of wine in the evening before bed.
- C. A couple of crackers with cheese and a glass of milk may help to relax before bed.
- D. I should go to the gym earlier in the day so that I’m done at least 6 hours before bedtime.
Correct Answer: B
Rationale: The correct answer is B. Alcohol disrupts sleep architecture, making it counterproductive for sleep hygiene. Getting up after 20 minutes (A) is a recommended practice, and exercising early (D) promotes better sleep.
A patient with trigeminal neuralgia has moderate to severe burning and shooting pain. In helping the patient to manage the pain, the nurse recognizes what about this type of pain?
- A. Treatment includes the use of adjuvant analgesics
- B. Will be chronic in nature and require long-term treatment
- C. Responds to small to moderate around-the-clock doses of oral opioids
- D. Can be well controlled with salicylates or nonsteroidal antiinflammatory drugs (NSAIDs)
Correct Answer: B
Rationale: The correct answer is B. Trigeminal neuralgia is chronic and often requires long-term management.
What drug would be most effective in relieving Mr. Stout’s bronchial spasm?
- A. Potassium iodide
- B. Ephedrine sulfate
- C. Cromolyn sodium
- D. Acetylcysteine (Mucomyst)
Correct Answer: B
Rationale: Ephedrine stimulates beta-adrenergic receptors, relaxing bronchial smooth muscle.
A patient is assessing a client who has just been admitted to the emergency department. The client is having difficulty breathing and is using accessory muscles. What action by the nurse is best?
- A. Administer oxygen at 2 liters per minute via nasal cannula.
- B. Assess the client's vital signs including oxygen saturation.
- C. Notify the Rapid Response Team immediately.
- D. Place the client in a high Fowler's position.
Correct Answer: D
Rationale: The correct answer is D: Place the client in a high Fowler's position. Placing the client in a high Fowler's position helps improve lung expansion and oxygenation by maximizing chest expansion. This position facilitates better breathing mechanics and can alleviate respiratory distress.
Choice A is incorrect because administering oxygen via nasal cannula should be done after positioning the client properly. Choice B is important but assessing vital signs alone may not provide immediate relief to the client's breathing difficulty. Choice C, notifying the Rapid Response Team, is not the best immediate action as positioning the client correctly should be the priority before seeking additional help.