Nokea
An adult patient has tested positive for tuberculosis (TB). While providing patient teaching, what information should the nurse prioritize?
- A. The importance of adhering closely to the prescribed medication regimen
- B. The fact that the disease is a lifelong, chronic condition that will affect ADLs
- C. The fact that TB is self-limiting, but can take up to 2 years to resolve
- D. The need to work closely with the occupational and physical therapists
Correct Answer: A
Rationale: Successful treatment of TB is highly dependent on careful adherence to the medication regimen. The disease is not self-limiting; occupational and physical therapy are not necessarily indicated. TB is curable.
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When assessing for substances that are known to harm workers lungs, the occupational health nurse should assess their potential exposure to which of the following?
- A. Organic acids
- B. Propane
- C. Asbestos
- D. Gypsum
Correct Answer: C
Rationale: Asbestos is among the more common causes of pneumoconiosis. Organic acids, propane, and gypsum do not have this effect.
The perioperative nurse is writing a care plan for a patient who has returned from surgery 2 hours prior. Which measure should the nurse implement to most decrease the patients risk of developing pulmonary emboli (PE)?
- A. Early ambulation
- B. Increased dietary intake of protein
- C. Maintaining the patient in a supine position
- D. Administering aspirin with warfarin
Correct Answer: A
Rationale: For patients at risk for PE, the most effective approach for prevention is to prevent deep vein thrombosis. Active leg exercises to avoid venous stasis, early ambulation, and use of elastic compression stockings are general preventive measures. The patient does not require increased dietary intake of protein directly related to prevention of PE, although it will assist in wound healing during the postoperative period. The patient should not be maintained in one position, but frequently repositioned, unless contraindicated by the surgical procedure. Aspirin should never be administered with warfarin because it will increase the patients risk for bleeding.
A patient has been brought to the ED by the paramedics. The patient is suspected of having ARDS. What intervention should the nurse first anticipate?
- A. Preparing to assist with intubating the patient
- B. Setting up oxygen at 5 L/minute by nasal cannula
- C. Performing deep suctioning
- D. Setting up a nebulizer to administer corticosteroids
Correct Answer: A
Rationale: A patient who has ARDS usually requires intubation and mechanical ventilation. Oxygen by nasal cannula would likely be insufficient. Deep suctioning and nebulizers may be indicated, but the priority is to secure the airway.
The nurse is caring for a patient in the ICU admitted with ARDS after exposure to toxic fumes from a hazardous spill at work. The patient has become hypotensive. What is the cause of this complication to the ARDS treatment?
- A. Pulmonary hypotension due to decreased cardiac output
- B. Severe and progressive pulmonary hypertension
- C. Hypovolemia secondary to leakage of fluid into the interstitial spaces
- D. Increased cardiac output from high levels of PEEP therapy
Correct Answer: C
Rationale: Systemic hypotension may occur in ARDS as a result of hypovolemia secondary to leakage of fluid into the interstitial spaces and depressed cardiac output from high levels of PEEP therapy. Pulmonary hypertension, not pulmonary hypotension, sometimes is a complication of ARDS, but it is not the cause of the patient becoming hypotensive.
A gerontologic nurse is teaching a group of medical nurses about the high incidence and mortality of pneumonia in older adults. What is a contributing factor to this that the nurse should describe?
- A. Older adults have less compliant lung tissue than younger adults
- B. Older adults are not normally candidates for pneumococcal vaccination
- C. Older adults often lack the classic signs and symptoms of pneumonia
- D. Older adults often cannot tolerate the most common antibiotics used to treat pneumonia
Correct Answer: C
Rationale: The diagnosis of pneumonia may be missed because the classic symptoms of cough, chest pain, sputum production, and fever may be absent or masked in older adult patients. Mortality from pneumonia in the elderly is not a result of limited antibiotic options or lower lung compliance. The pneumococcal vaccine is appropriate for older adults.