Nokea
Expected age-related changes of the pulmonary system include:
- A. Significant airway obstruction
- B. Shortness of breath
- C. Development of emphysema
- D. A modest,gradual decline in pulmonary function
Correct Answer: D
Rationale: While lung capacity decreases with age, it typically results in a gradual decline rather than significant obstruction or diseases like emphysema unless other factors (e.g., smoking) are present.
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What would be the best response by the nurse to a quiet and uncommunicative client?
- A. Think over the following questions.
- B. Discuss them with your instructor or peers.
- C. Acknowledge their feelings and encourage expression.
- D. Offer silence and wait patiently.
Correct Answer: D
Rationale: Silence can provide the client with space to open up when they feel ready, fostering trust and rapport.
Joan is diagnosed with a ruptured aneurysm. She wonders why this was not picked up in her annual physical. You respond by saying
- A. The physician must have misread the x-ray.
- B. The aneurysm must have developed since the physical.
- C. Aneurysms are often asymptomatic.
- D. Do not be too concerned because this happens all the time.
Correct Answer: C
Rationale: Aneurysms can develop silently without noticeable symptoms.
Your patient is often fatigued as a result of having anemia. She asks you why she is fatigued. You respond by saying
- A. Destruction (hemolysis) of the red blood cells.
- B. Paleness (pallor) of the skin.
- C. Lack of nutritional intake of essential nutrients, such as iron or B12.
- D. Decreased oxygen-carrying capability of the blood.
Correct Answer: D
Rationale: Anemia reduces the blood's ability to carry oxygen, leading to fatigue.
To prevent a common, adverse effect of prolonged use of phenytoin sodium (Dilantin), patients taking the drug are instructed to
- A. avoid crowds and obtain an annual influenza vaccination.
- B. drink at least 2 L of fluids daily, including 8 to 10 glasses of water.
- C. eat a potassium-rich, low-sodium diet.
- D. practice good dental hygiene and report gum swelling or bleeding.
Correct Answer: D
Rationale: Phenytoin can cause gum hyperplasia, so good dental hygiene is essential.
Yesterday, a male client had a transurethral resection of the prostate (TURP). Today, the client is concerned about the small amount of blood found in his urine. The nurse should explain to the client that the blood:
- A. should not be there on the second day.
- B. will stop when the Foley catheter is removed.
- C. is normal and he should not be concerned.
- D. can be removed by irrigating the bladder.
Correct Answer: C
Rationale: Some hematuria is usual for several days after surgery. The client should not be concerned, unless the amount increases. The client will continue to have a small amount of hematuria even after the Foley catheter is removed. Some hematuria is usual for several days after surgery. The client should not be concerned, unless the amount increases. Irrigating the bladder will not remove the hematuria. Irrigation is performed to remove blood clots and to facilitate urinary drainage.