Nokea
After a case manager completes a history and physical assessment for a client with COPD, which of the following actions should the case manager take next?
- A. Call the provider with a list of client concerns.
- B. Identify the client's current health needs.
- C. Compile a list of community resources for the client.
- D. Refer the client to a COPD support group.
Correct Answer: A
Rationale: After completing a history and physical assessment for a client with COPD, the next step for the case manager should be to call the provider with a list of client concerns. This is crucial as the provider needs to be informed about any issues or changes in the client's health status to ensure appropriate management. Identifying the client's current health needs, as mentioned in option B, is important but would typically follow after communicating the client's concerns to the provider. Compiling a list of community resources (option C) and referring the client to a COPD support group (option D) are also valuable actions but are not the immediate next steps after completing the assessment.
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What are the nursing interventions for a patient with pneumonia?
- A. Providing fluids and rest
- B. Monitoring lung sounds and respiratory rate
- C. Encouraging coughing and deep breathing exercises
- D. Administering antibiotics and providing oxygen therapy
Correct Answer: B
Rationale: The correct nursing interventions for a patient with pneumonia include monitoring lung sounds and respiratory rate to assess the effectiveness of treatment and the patient's respiratory status. Providing fluids and rest (Choice A) can be supportive measures but are not specific nursing interventions for pneumonia. Encouraging coughing and deep breathing exercises (Choice C) can be helpful for airway clearance but may not be appropriate for all patients with pneumonia. Administering antibiotics and providing oxygen therapy (Choice D) are medical interventions rather than nursing interventions.
A client has a new prescription for guaifenesin. What information regarding the action of guaifenesin should the nurse include in the teaching?
- A. Decreases mucus production
- B. Reduces nasal congestion
- C. Increases cough production
- D. Reduces fever
Correct Answer: C
Rationale: The correct answer is C: 'Increases cough production.' Guaifenesin is an expectorant that works by increasing cough production to help clear secretions from the airways. Option A is incorrect because guaifenesin does not decrease mucus production but rather helps to make the mucus easier to cough up. Option B is incorrect as guaifenesin does not reduce nasal congestion. Option D is incorrect because guaifenesin does not have any effect on reducing fever.
A patient with a history of hypertension is admitted for chest pain. What is the most appropriate action for the nurse to take first?
- A. Obtain a detailed medical history
- B. Administer nitroglycerin
- C. Conduct an ECG
- D. Administer morphine sulfate
Correct Answer: B
Rationale: The correct answer is to administer nitroglycerin. Nitroglycerin is the priority intervention for a patient presenting with chest pain as it helps dilate blood vessels, reduce chest pain, and improve oxygen supply to the heart. Obtaining a detailed medical history, conducting an ECG, or administering morphine sulfate are important steps in the assessment and treatment process but are secondary to the immediate need to address chest pain and potential cardiac ischemia.
A client in her first trimester of pregnancy is being taught by a nurse about over-the-counter medications that belong to pregnancy risk category B. Which of the following medications should the nurse include?
- A. Naproxen
- B. Aspirin
- C. Ibuprofen
- D. Acetaminophen
Correct Answer: D
Rationale: Acetaminophen is the correct choice as it belongs to pregnancy risk category B, making it considered safe during pregnancy. Naproxen, Aspirin, and Ibuprofen are not recommended during pregnancy, especially in the first trimester, as they are classified in higher-risk categories which may be harmful to the developing fetus.
A healthcare professional is assessing a client 15 minutes after administering morphine sulfate 2 mg via IV push. The healthcare professional should identify which of the following findings as an adverse effect of the medication?
- A. Drowsy but responsive when her name is called
- B. SaO2 94%
- C. Respiratory rate 8/min
- D. Pain level of 6 on a scale from 0 to 10
Correct Answer: C
Rationale: A respiratory rate of 8/min is a significant adverse effect of morphine that indicates respiratory depression, which requires immediate intervention to prevent further complications. The client may not be effectively ventilating, leading to hypoxia and respiratory acidosis. Option A is less concerning as being drowsy but responsive is a common side effect of morphine. Option B indicates decreased oxygen saturation, which is also a concern but not as severe as respiratory depression. Option D is important but not as critical as the potential respiratory compromise indicated by the low respiratory rate.