Nokea
On assessing Mr. Puff, what would you expect to find?
- A. ‘Blue bloater’ appearance
- B. Copious amount of thin sputum
- C. Increased anteroposterior chest diameter
- D. Prolonged inspiratory time
Correct Answer: C
Rationale: The correct answer is C: Increased anteroposterior chest diameter. In patients with chronic obstructive pulmonary disease (COPD), like Mr. Puff, there is often air trapping leading to hyperinflation of the lungs. This results in an increased anteroposterior chest diameter, known as a "barrel chest" appearance. Option A (‘Blue bloater’ appearance) is associated with chronic bronchitis, not necessarily COPD. Option B (Copious amount of thin sputum) is more indicative of bronchiectasis. Option D (Prolonged inspiratory time) is a nonspecific finding and not typically associated with COPD.
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Which of the four phases of pain transmission is characterized by the peripheral nerve fibers forming synapses with neurons in the spinal cord and the pain impulses moving away from the spinal cord to the reticular activating system, the limbic system, the thalamus, and finally the cerebral cortex?
- A. Modulation
- B. Transduction
- C. Transmission
- D. Perception
Correct Answer: C
Rationale: The correct answer is C because during the transmission phase, pain signals are relayed from the spinal cord to various parts of the brain for processing.
What is the main risk factor for developing presbycusis?
- A. Age
- B. Noise exposure
- C. Genetics
- D. All of the above
Correct Answer: A
Rationale: Age is the primary risk factor for presbycusis, a form of age-related hearing loss.
While recovering from the anesthetic, what is the best position for Mrs. West?
- A. Supine with legs fully extended
- B. Prone with head turned to the side
- C. Lateral Sims with legs flexed
- D. Trendelenburg with head to the side
Correct Answer: D
Rationale: The correct answer is D: Trendelenburg with head to the side. This position helps prevent aspiration by promoting drainage of secretions from the mouth and reducing the risk of airway obstruction. Placing the patient in Trendelenburg position with the head to the side also helps facilitate proper blood flow and ventilation. Supine with legs fully extended (A) may increase the risk of airway obstruction and aspiration. Prone with head turned to the side (B) may obstruct the airway and hinder breathing. Lateral Sims with legs flexed (C) is not suitable for a patient recovering from anesthesia as it may not provide optimal airway clearance and respiratory support.
What are these sensory phenomena called when a client hears voices or sees images that do not objectively exist?
- A. Mania
- B. Delusions
- C. Seasonal affective disorder
- D. Hallucinations
Correct Answer: D
Rationale: Hallucinations involve perceiving things that are not present, such as hearing voices or seeing images.
A client had a total hip arthroplasty. Which of the following prescriptions should the nurse verify with the provider?
- A. Administer enoxaparin 30 mg subcutaneously every 12 hr
- B. Place a wedge or pillow between the client's legs when turning.
- C. Instruct the client to restrict flexion of the hip past 120°.
- D. Encourage the client to perform foot and calf exercises every 2 hr
Correct Answer: C
Rationale: The correct answer is C because restricting flexion of the hip past 120° is crucial to prevent dislocation of the prosthetic hip joint post-operatively. Excessive flexion can lead to instability and potential complications. The other options are important but do not directly relate to the risk of hip dislocation. Administering enoxaparin helps prevent blood clots, using a wedge or pillow between the legs promotes proper alignment and comfort, and performing foot and calf exercises aids in preventing blood clots as well. However, restricting hip flexion is the most critical for the client's safety and optimal recovery after a total hip arthroplasty.