Nokea
List at least three behaviors or practices that can contribute to insomnia.
- A. Irregular sleep schedule
- B. Consumption of caffeine or alcohol
- C. Excessive screen time before bed
- D. Provide enough positive pressure in the airway to prevent airway collapse
Correct Answer: A
Rationale: The correct answers are A, B, and C. Irregular sleep schedules, caffeine/alcohol consumption, and excessive screen time disrupt sleep patterns, contributing to insomnia.
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A client just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?
- A. Withhold food and liquids until the client's gag reflex returns.
- B. Irrigate the client's throat every 4 hours.
- C. Have the client refrain from talking for 24 hours.
- D. Suction the client's oropharynx frequently.
Correct Answer: A
Rationale: The correct answer is A: Withhold food and liquids until the client's gag reflex returns. After a flexible bronchoscopy, the client may have a decreased gag reflex due to topical anesthesia used during the procedure, which increases the risk of aspiration. Withholding food and liquids helps prevent aspiration until the gag reflex returns, usually within 1-2 hours.
B: Irrigating the client's throat every 4 hours is unnecessary and may not be indicated post-bronchoscopy.
C: Having the client refrain from talking for 24 hours is not necessary after a flexible bronchoscopy unless specifically instructed by the healthcare provider.
D: Suctioning the client's oropharynx frequently is not indicated unless there is a clinical indication for it, such as excessive secretions or respiratory distress. Frequent suctioning can increase the risk of trauma to the airway.
For each of the following body systems, identify three physical manifestations that the nurse would expect to see in a patient approaching death.
- A. Respiratory: Cheyne-Stokes respirations
- B. Skin: Mottling
- C. Gastrointestinal: Loss of appetite
- D. Musculoskeletal: Weakness
Correct Answer:
Rationale:
The nurse understands that during the 'tension building' phase of a violent relationship, when the batterer makes unreasonable demands, the battered victim may experience feelings of:
- A. Anger.
- B. Helplessness.
- C. Calm.
- D. Explosive.
Correct Answer: B
Rationale: Victims often feel powerless and trapped during this phase.
A client presents with shortness of breath, pain in the lung area, and a recent history of starting birth control pills and smoking. Vital signs include a heart rate of 110/min, respiratory rate of 40/min, and blood pressure of 140/80 mm Hg. Arterial blood gases reveal pH 7.50, PaCO2 29 mm Hg, PaO2 60 mm Hg, HCO3 20 mEq/L, and SaO2 86%. What is the priority nursing intervention?
- A. Prepare for mechanical ventilation.
- B. Administer oxygen via face mask.
- C. Prepare to administer a sedative.
- D. Assess for indications of pulmonary embolism.
Correct Answer: B
Rationale: The correct answer is B: Administer oxygen via face mask. Given the client's symptoms and ABG results showing respiratory alkalosis and hypoxemia, the priority is to improve oxygenation. Administering oxygen via face mask will help increase the oxygenation levels and alleviate the hypoxemia. Mechanical ventilation (A) is not indicated as the client is able to maintain their own ventilation. Administering a sedative (C) is not appropriate without addressing the underlying respiratory issue. Assessing for pulmonary embolism (D) may be important but not the immediate priority in this case.
A primary nursing responsibility is the prevention of lung cancer by assisting patients in smoking/tobacco cessation. Which task would be appropriate to delegate to the LPN/LVN?
- A. Develop a 'quit plan'.
- B. Discuss strategies to avoid relapse.
- C. Explain the application of a nicotine patch.
- D. Suggest ways to deal with urges for tobacco.
Correct Answer: C
Rationale: Explaining the application of a nicotine patch is a technical task that LPNs/LVNs can perform, while developing plans or discussing strategies require more specialized knowledge.