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Delegation Decision: The nurse is caring for a patient with COPD. Which intervention could be delegated to unlicensed assistive personnel (UAP)?
- A. Assist the patient to get out of bed.
- B. Auscultate breath sounds every 4 hours.
- C. Plan patient activities to minimize exertion.
- D. Teach the patient pursed lip breathing technique.
Correct Answer: A
Rationale: Assisting the patient to get out of bed can be safely delegated to unlicensed assistive personnel (UAP) as it does not require specialized nursing knowledge or skills. It is a basic activity of daily living that can be delegated to support staff while allowing nurses to focus on more complex patient care tasks.
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Chlorocruorin is a copper-containing blood pigment found in some annelids like Sabella. Its colour in both oxygenated and deoxygenated states is
- A. Blue
- B. Red
- C. Green
- D. Blue red
Correct Answer: C
Rationale: Step 1: Chlorocruorin contains copper, giving it a green color.
Step 2: In oxygenated state, chlorocruorin appears green due to the presence of copper.
Step 3: In deoxygenated state, chlorocruorin retains its green color.
Step 4: Therefore, the correct answer is C: Green.
Summary: A (Blue) and B (Red) are incorrect as chlorocruorin is green due to copper. D (Blue red) is incorrect as it does not reflect the true color of chlorocruorin.
A nurse teaches a client who is prescribed nicotine replacement therapy. Which statement would the nurse include in this client's teaching?
- A. Make a list of reasons why smoking is a bad habit.
- B. Rise slowly when getting out of bed in the morning.
- C. Smoking while taking this medication will increase your risk of a stroke.
- D. Stopping this medication suddenly increases your risk for a heart attack.
Correct Answer: C
Rationale: The correct answer is C: Smoking while taking this medication will increase your risk of a stroke. This statement is important because nicotine replacement therapy aims to help the client quit smoking, and smoking while on this therapy can lead to nicotine overdose, increasing the risk of adverse effects like stroke.
Choice A is incorrect as it does not directly relate to the client's nicotine replacement therapy. Choice B is incorrect as it pertains to orthostatic hypotension, not nicotine replacement therapy. Choice D is incorrect as it addresses the consequences of abruptly stopping the medication, not the risks associated with smoking while on it.
After receiving a change-of-shift report on four patients admitted to a heart failure unit ,which patient should the nurse assess first?
- A. A patient who reported dizziness after receiving the first dose of captopril.
- B. A patient who has new-onset confusion and restlessness and cool clammy skin.
- C. A patient who is receiving IV nesiritide (Natrecor)
- D. A patient who is receiving oxygen and has crackles bilaterally in the lung bases.
Correct Answer: B
Rationale: The correct answer is B because new-onset confusion, restlessness, and cool clammy skin are signs of poor perfusion and potential deterioration. The nurse should assess this patient first to address possible acute changes in condition. Option A, dizziness after captopril, can be important but not immediately life-threatening. Option C receiving IV nesiritide is stable and monitored closely. Option D with oxygen and crackles indicates pulmonary congestion but is not an immediate priority compared to the signs of poor perfusion in option B.
A client is admitted with chronic obstructive pulmonary disease (COPD). Which of the following signs and symptoms aren't characteristic of COPD?
- A. Fever
- B. Dyspnea on exertion.
- C. Barrel chest.
- D. Clubbed fingers and toes.
Correct Answer: A
Rationale: The correct answer is A: Fever. Fever is not a characteristic sign or symptom of COPD. The rationale is that COPD is a chronic respiratory condition that primarily affects the lungs and airways, leading to symptoms such as shortness of breath (dyspnea on exertion), barrel chest due to air trapping, and clubbed fingers and toes due to chronic hypoxia. Fever is not a typical presentation of COPD, as it is usually associated with infections or inflammatory conditions rather than COPD itself. In summary, choices B, C, and D are characteristic of COPD, while choice A is not typically associated with this condition.
The process of respiration is concerned with
- A. Intake O2
- B. Liberation of O2
- C. Liberation of CO2
- D. liberation of energy
Correct Answer: D
Rationale: The correct answer is D: liberation of energy. Respiration involves the conversion of glucose into ATP, releasing energy that cells can use for various functions. Oxygen is taken in during respiration (A), not liberated (B). Carbon dioxide is released (C) as a byproduct of respiration, not liberated. Option D is correct as it accurately captures the primary purpose of respiration.