Nokea
Select all the following that can trigger an asthma attack:
- A. Sulfites
- B. Smoke
- C. Caffeine
- D. GERD
- E. Cold, windy weather
- F. Beta agonist
- G. Cockroaches
Correct Answer: A,B,D,E,G
Rationale: Triggers include sulfites, smoke, GERD, cold weather, and cockroaches. Caffeine and beta agonists are not typical triggers; beta agonists are treatments.
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The male client has had a radial neck dissection for cancer of the larynx. Which action by the client indicates a disturbance in body image?
- A. The client requests a consultation by the speech therapist.
- B. The client has a towel placed over the mirror.
- C. The client is attempting to shave himself.
- D. The client practices neck and shoulder exercises.
Correct Answer: B
Rationale: Placing a towel over the mirror (choice 2) suggests the client is avoiding looking at their altered appearance due to the radical neck dissection, indicating a disturbance in body image. This surgery often results in visible changes, such as scarring or a tracheostomy, which can impact self-perception. Requesting a speech therapist (choice 1) focuses on communication, attempting to shave (choice 3) shows engagement in self-care, and practicing exercises (choice 4) indicates recovery efforts, none of which directly reflect body image issues.
The nurse suspects the client admitted with a near-drowning is developing acute respiratory distress syndrome (ARDS). Which data support the nurse's suspicion?
- A. The client's arterial blood gases are within normal limits.
- B. The client appears anxious, has dyspnea, and is tachypneic.
- C. The client has intercostal retractions and is using accessory muscles.
- D. The client has bilateral lung sounds with crackles and rhonchi.
Correct Answer: C
Rationale: Intercostal retractions and accessory muscle use (C) indicate severe respiratory distress, consistent with ARDS due to increased work of breathing from reduced lung compliance. Normal ABGs (A) contradict ARDS, which involves hypoxia. Anxiety, dyspnea, and tachypnea (B) are non-specific. Crackles and rhonchi (D) may occur but are less specific than physical signs of distress.
An adult client is to have postural drainage four times a day. In developing the care plan, the nurse should schedule this for:
- A. 7 A.M.; 11 A.M.; 4 P.M.; 10 P.M.
- B. 10 A.M.; 2 P.M.; 6 P.M.; 10 P.M.
- C. 6 A.M.; 12 noon; 6 P.M.; 12 midnight
- D. 6 A.M.; 10 A.M.; 2 P.M.; 6 P.M.
Correct Answer: A
Rationale: Postural drainage should be scheduled before or between meals and close to bedtime to avoid interference with digestion and ensure effectiveness, making 7 A.M., 11 A.M., 4 P.M., and 10 P.M. the best schedule.
The client diagnosed with a community-acquired pneumonia is being admitted to the medical unit. Which nursing intervention has the highest priority?
- A. Administer the ordered oral antibiotic immediately (STAT).
- B. Order the meal tray to be delivered as soon as possible.
- C. Obtain a sputum specimen for culture and sensitivity.
- D. Have the unlicensed assistive personnel weigh the client.
Correct Answer: C
Rationale: Obtaining sputum culture (C) before antibiotics ensures accurate pathogen identification, a priority. Antibiotics (A) follow, meals (B) and weight (D) are less urgent.
The nurse is caring for a client with a right-sided chest tube secondary to a pneumothorax. Which interventions should the nurse implement when caring for this client? Select all that apply.
- A. Place the client in the low Fowler's position.
- B. Assess chest tube drainage system frequently.
- C. Maintain strict bedrest for the client.
- D. Secure a loop of drainage tubing to the sheet.
- E. Observe the site for subcutaneous emphysema.
Correct Answer: B
Rationale: Frequent system checks (B), securing tubing (D), and monitoring emphysema (E) ensure chest tube function. Low Fowler’s (A) is incorrect (semi-Fowler’s preferred), and bedrest (C) is unnecessary.