Nokea
How can a nurse provide culturally competent care to all individuals?
- A. Become familiar with physical differences among ethnic groups.
- B. Learn to speak a second language.
- C. Develop strategies to avoid cultural imposition.
- D. Consult the client about ways to solve health problems.
Correct Answer: C
Rationale: Avoiding cultural imposition ensures respect for individual preferences and promotes inclusive care practices.
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List the order for the actions that you must perform.
- A. Perform the chin lift or jaw thrust maneuver
- B. Establish unresponsiveness
- C. Initiate cardiopulmonary resuscitation (CPR)
- D. Call for help and activate the code team
Correct Answer: B
Rationale: Establishing unresponsiveness is the first step in assessing the patient's condition.
Before administering oxygen to a patient, what should the nurse initially do?
- A. Observe the patient’s respiratory pattern
- B. Monitor the arterial blood gas results
- C. Determine if the patient has a history of COPD
- D. Ask the patient if he prefers nasal or mask O₂
Correct Answer: A
Rationale: Assessing respiratory effort helps tailor oxygen therapy appropriately.
A 27-year-old male client develops malignant hyperthermia during a herniorrhaphy; his temperature is 105.4 degrees F. The client has had no previous health problems other than hypertension. A nurse orienting in the OR says, 'I thought only people with brain tumors had this problem.' Which of the following answers explains malignant hyperthermia?
- A. Epinephrine increased the basal metabolic rate as soon as the general anesthesia was administered.
- B. The blood flow to active muscles increased with a concurrent decrease in the blood flow to the organs not needed for rapid activity.
- C. The catecholamines released led to activation of the sympathetic nervous system.
- D. Malignant hyperthermia is an inherited disorder of muscle metabolism that causes fever, increased heart rate, and rapid breathing.
Correct Answer: D
Rationale: Epinephrine is a hormone employed in the fight-or-flight stress response. It does not contribute to malignant hyperthermia. Stimulation of the sympathetic adrenal medullary mechanism helps the body cope with stress. It does not contribute to malignant hyperthermia. Catecholamine release is one of the physiological effects of stress. It does not contribute to malignant hyperthermia. Malignant hyperthermia is an inherited disorder of muscle metabolism that increases intracellular calcium, which causes generalized muscle rigidity, fever, tachycardia, and tachypnea.
A home health nurse visits a client who has COPD and receives oxygen at 2 L/min via nasal cannula. The client reports difficulty breathing. Which of the following actions is the nurse's priority?
- A. Increase the oxygen flow to 3 L/min.
- B. Assess the client's respiratory status.
- C. Call emergency services for the client.
- D. Have the client cough and expectorate secretions.
Correct Answer: B
Rationale: The correct answer is B: Assess the client's respiratory status. This is the priority because the client is experiencing difficulty breathing, which could indicate a worsening of their condition. By assessing the respiratory status, the nurse can gather vital information to determine the appropriate next steps, such as adjusting the oxygen flow rate, providing respiratory treatments, or seeking further medical intervention. Increasing the oxygen flow without assessing the client's condition could potentially exacerbate the issue. Calling emergency services (choice C) may be necessary based on the assessment findings but should not be the immediate priority. Having the client cough and expectorate secretions (choice D) is important for airway clearance but is not the priority when the client is in distress.
A client with COPD is developing a plan of care. Which of the following interventions should the nurse include in the plan?
- A. Restrict the client's fluid intake to less than 2 L/day
- B. Provide the client with a low-protein diet
- C. Have the client use the early-morning hours for exercise and activity
- D. Instruct the client to use pursed-lip breathing
Correct Answer: D
Rationale: The correct answer is D: Instruct the client to use pursed-lip breathing. Pursed-lip breathing helps improve ventilation and decrease air trapping in clients with COPD, enhancing oxygenation and reducing shortness of breath. It also facilitates better gas exchange and can help the client manage their symptoms effectively.
A: Restricting fluid intake is not typically indicated for clients with COPD unless they have comorbid conditions that require fluid restriction.
B: Providing a low-protein diet is not a standard intervention for COPD management. Protein is important for muscle strength and repair in these clients.
C: While exercise and activity are beneficial for clients with COPD, instructing them to do so specifically in the early-morning hours is not a priority intervention compared to pursed-lip breathing.