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A client with a long history of smoking is being assessed by a nurse. Which finding is a common complication of chronic obstructive pulmonary disease (COPD)?
- A. Decreased anteroposterior chest diameter
- B. Increased breath sounds
- C. Prolonged expiratory phase
- D. Increased chest expansion
Correct Answer: C
Rationale: Step-by-step rationale:
1. COPD is characterized by airway obstruction, leading to difficulty exhaling.
2. Prolonged expiratory phase is a common finding due to air trapping.
3. This leads to hyperinflation and increased residual volume.
4. Decreased anteroposterior chest diameter is not typical in COPD.
5. Increased breath sounds and chest expansion are not common in COPD.
In summary, choice C is correct because it directly relates to the pathophysiology of COPD, while the other choices are not consistent with the condition.
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A client with Parkinson's disease is prescribed carbidopa-levodopa (Sinemet). What should the nurse include in the teaching about this medication?
- A. Take the medication without a high-protein meal.
- B. Expect the medication to take several weeks to reach full effectiveness.
- C. The medication may cause urine to turn light.
- D. You may experience a rapid heartbeat as a common side effect.
Correct Answer: B
Rationale: The correct answer is B: Expect the medication to take several weeks to reach full effectiveness. This is because carbidopa-levodopa (Sinemet) is a medication used to treat Parkinson's disease by increasing dopamine levels in the brain. It takes time for the medication to build up in the system and reach its full therapeutic effect.
Choice A is incorrect because it is recommended to take carbidopa-levodopa with a high-protein meal to help reduce potential gastrointestinal side effects. Choice C is incorrect as the medication does not typically cause urine discoloration. Choice D is incorrect as a rapid heartbeat is not a common side effect of carbidopa-levodopa.
In summary, choice B is correct because it aligns with the pharmacokinetics of the medication, while the other choices are not consistent with the usual effects and recommendations for carbidopa-levodopa.
What behavioral clues will you watch for to identify an increased risk for suicide?
- A. Deep breathing exercises
- B. Avoid social interactions
- C. Ignore stressors
- D. Increase workload
Correct Answer: D
Rationale: The correct answer is D because it is the most appropriate response based on physiological and medical principles.
Identify the options for communication with each type of client: A client who has suffered a stroke, has expressive aphasia, and has lost use of their dominant hand.
- A. Use written communication and visual aids.
- B. Ask a family member to interpret.
- C. Speak louder and slower.
- D. Use sign language.
Correct Answer: A
Rationale: Written communication and visual aids help bridge the gap caused by expressive aphasia and physical limitations.
A client with a spinal cord injury at T6 suddenly reports a pounding headache and blurred vision. What action should the nurse take first?
- A. Administer pain medication as ordered.
- B. Check the client's blood pressure.
- C. Place the client in a supine position.
- D. Increase the client's fluid intake.
Correct Answer: B
Rationale: The correct action is to check the client's blood pressure first. A sudden onset of pounding headache and blurred vision in a client with a spinal cord injury at T6 can indicate autonomic dysreflexia. Checking the blood pressure is crucial as autonomic dysreflexia can lead to severe hypertension, which can result in life-threatening complications such as stroke or seizure. Immediate assessment and intervention are necessary to prevent further harm. Administering pain medication without addressing the underlying cause can exacerbate hypertension. Placing the client in a supine position can worsen symptoms, and increasing fluid intake does not address the immediate issue at hand. Therefore, checking the blood pressure is the priority to identify and manage autonomic dysreflexia effectively.
During a preoperative review of systems, the patient reveals a history of renal disease. This finding suggests the need for which preoperative diagnostic tests?
- A. ECG and chest x-ray
- B. Serum glucose and CBC
- C. ABGs and coagulation tests
- D. BUN, serum creatinine, and electrolytes
Correct Answer: D
Rationale: Renal disease necessitates evaluating kidney function through tests like BUN, serum creatinine, and electrolytes.