Nokea
Lucinda is a 27-year-old woman with a history of asthma who is scheduled for an appendectomy later today. Due to her asthma, her preoperative teaching would include the need for postoperative:
- A. coughing and deep breathing exercises.
- B. leg exercises.
- C. wound dressing changes.
- D. all of the above.
Correct Answer: A
Rationale: Patients with asthma are at higher risk for respiratory complications postoperatively. Coughing and deep breathing exercises help prevent atelectasis and pneumonia, making them essential for this patient.
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A client in the emergency department is being cared for by a nurse and has cardiogenic pulmonary edema. The client's assessment findings include anxiousness, dyspnea at rest, crackles, blood pressure 110/79 mm Hg, and apical heart rate 112/min. What is the nurse's priority intervention?
- A. Provide the client with supplemental oxygen at 5 L/min via facemask.
- B. Place the client in high-Fowler's position with their legs in a dependent position
- C. Give the client sublingual nitroglycerin
- D. Administer morphine sulfate IV
Correct Answer: A
Rationale: The correct answer is A: Provide the client with supplemental oxygen at 5 L/min via facemask. In cardiogenic pulmonary edema, the priority intervention is to improve oxygenation. Supplemental oxygen helps increase oxygen levels and alleviate respiratory distress, reducing the workload on the heart. This intervention addresses the client's dyspnea and anxiousness by improving oxygen delivery.
Choice B is incorrect as placing the client in high-Fowler's position with legs in a dependent position can help with breathing but does not address the immediate need for oxygenation.
Choice C is incorrect as sublingual nitroglycerin is typically used for angina and not the priority intervention for cardiogenic pulmonary edema.
Choice D is incorrect as morphine sulfate IV may be indicated for pain relief and anxiety, but it is not the priority intervention to address the client's oxygenation needs in cardiogenic pulmonary edema.
Vince has been taking excessive amounts of over-the-counter antacid tablets. He has been exhibiting signs of irritability, anxiety, muscle cramping, and weakness, and has recently developed tetany. The physician has initiated seizure precautions. He recognizes that the patient is being monitored and treated for:
- A. Hyperkalemia.
- B. Hyperphosphatemia.
- C. Metabolic acidosis.
- D. Metabolic alkalosis.
Correct Answer: D
Rationale: The correct answer is Metabolic alkalosis (D). Excessive intake of antacids containing bicarbonate or calcium carbonate can lead to metabolic alkalosis. Symptoms such as irritability, anxiety, muscle cramping, weakness, and tetany are consistent with elevated blood pH levels due to increased bicarbonate levels.
What nursing measure would be most helpful in obtaining Mr. Smith’s compliance with treatment?
- A. Involve Mrs. Smith in the teaching sessions
- B. Teach Mr. Smith about his prescribed medications
- C. Ask the social worker to talk to Mr. Smith
- D. Refer the Smiths to the American Lung Association
Correct Answer: B
Rationale: Education empowers patients to understand and adhere to their treatment plans.
What prevents disorientation in older clients with hearing impairments?
- A. Use of written notes and a walking cane for proper balance
- B. Refer to a local support or self-help group
- C. Frequent contact and reorientation
- D. Avoid frequent outdoor activities
Correct Answer: C
Rationale: Regular reorientation and interaction help maintain cognitive and spatial awareness.
Most of the danger associated with pneumoconioses is due to
- A. Unnecessary anxiety created by environmentalists
- B. The dark, wet mining environment
- C. Inhalation and retention of dust particles
- D. The fact that most miners also smoke cigarettes
Correct Answer: C
Rationale: Inhaling dust particles damages lung tissue, leading to fibrosis.