Nokea
Nurses who rotate shifts or work nights are at risk for developing shift work sleep disorder characterized by insomnia, sleepiness, and fatigue. Identify at least three negative implications for the nurse.
- A. Increased risk of errors
- B. Decreased job satisfaction
- C. Higher likelihood of accidents
- D. Sleep just before going to work
Correct Answer: A
Rationale: The correct answers are A, B, and C. Shift work sleep disorder increases the risk of errors, reduces job satisfaction, and raises the likelihood of accidents due to impaired alertness.
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During assessment, a healthcare provider is evaluating a client with chronic bronchitis. Which of the following percussion sounds should the healthcare provider expect?
- A. Dullness
- B. Resonance
- C. Tympany
- D. Flatness
Correct Answer: B
Rationale: The correct answer is B: Resonance. When assessing a client with chronic bronchitis, the healthcare provider should expect to hear resonant percussion sounds. This is because chronic bronchitis is characterized by inflammation and excess mucus production in the bronchial tubes, leading to airway obstruction. Resonance indicates normal lung tissue and air-filled spaces. Dullness (A) may suggest consolidation or fluid in the lungs, which is not typically associated with chronic bronchitis. Tympany (C) is a drum-like sound that can be heard over air-filled structures like the stomach, not typically expected in a lung assessment. Flatness (D) is heard over solid structures like the liver and would not be expected in a lung assessment for chronic bronchitis.
Who should ideally do discharge planning?
- A. Practical nurse
- B. Professional nurse and the patient
- C. Patient and his family
- D. Public health nurse
Correct Answer: B
Rationale: Collaboration between the professional nurse and the patient ensures personalized and effective discharge planning.
For your patient with a CD4 count, less than 200, the most important nursing assessment would include
- A. Bowel movements.
- B. Urinary output.
- C. Fever.
- D. Blood pressure.
Correct Answer: C
Rationale: Fever can indicate opportunistic infections in immunocompromised patients.
Which stage of wound healing lasts from 21 days to several months and even 1 to 2 years, allowing the strength of the wound to increase through synthesis of collagen by fibroblasts and lysis by collagenase enzymes?
- A. Inflammatory stage
- B. Proliferative phase
- C. Maturation phase
- D. Approximation phase
Correct Answer: C
Rationale: The correct answer is C because the maturation phase involves collagen remodeling and strengthening.
Jill Means, 36, has had a vaginal radium implant placed as one of the treatments for her cervical cancer. She calls to tell you that during a coughing spell it has 'been pushed out'. You should:
- A. place signs on the door stating radioactivity danger.
- B. have Jill reinsert the applicator like a tampon.
- C. call the physician and apprise him of the situation.
- D. use forceps to place the applicator in the receptacle.
Correct Answer: D
Rationale: Signs should be placed on the door after the implant has been done, and not just when the implant is dislodged. By picking the applicator up, Jill would experience burns on her fingers/hands that would be avoidable, so need to teach her not to do so. The applicator has been contaminated, it would not be replaced in any case. Calling the physician and apprising him would certainly be necessary, but would be done after the applicator has been taken care of. Lead containers should be available to place the applicator in, and forceps would be used to do so to protect from radiation burns.