Nokea
Self-management is an important principle in optimal management and prevention of exacerbation. In order for the patient to self-manage appropriately, which of the following is not required?
- A. Understanding of the pathophysiology of disease, nature of inflammation and bronchoconstriction and trigger avoidance
- B. Education on medication compliance, use of devices and correct inhalation technique, as well as when to increase dosage
- C. Assessment by multidisciplinary team to address additional health concerns
- D. Development of an action plan in knowledge on when to implement and when to seek assistance
Correct Answer: C
Rationale: Asthma self-rule needs know-how pathology, meds, triggers, action plans not a full team probe. That's extra, not must-have; core's patient-led. Nurses train this, a chronic solo skill.
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A nurse is caring for a 65-year-old male who recently underwent an aortic valve replacement. Which of the following is a post-operative nursing care priority?
- A. Temperature monitoring
- B. Assess for bleeding
- C. Advance diet as tolerated
- D. Dressing change
Correct Answer: B
Rationale: Valve replacement bleeds assessing for hemorrhage at surgical sites or anticoagulation tops post-op care, a life-or-death watch per ABCs. Fever, diet, dressings matter, but bleeding's immediate. Nurses hunt oozing or shock, ensuring stability, a priority in this fresh-cut cardiac zone.
A patient who has severe pain associated with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching regarding pain management has been effective?
- A. The patient uses the ordered opioid pain medication whenever the pain is greater than 5 (0 to 10 scale).
- B. The patient agrees to take the medications by the IV route in order to improve analgesic effectiveness.
- C. The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.
- D. The patient states that nonopioid analgesics may be used when the maximal dose of the opioid is reached without adequate pain relief.
Correct Answer: C
Rationale: Terminal pancreatic cancer pain's relentless around-the-clock opioids with breakthrough doses keep it tamed, per hospice norms. Waiting for 5/10 lags; IV isn't inherently better oral's fine. Nonopioids at max opioid miss the mark escalation's the play. Nurses in oncology teach this steady dosing plus rescues nails chronic cancer pain, a win if families get it.
A client with a history of prostate cancer is in the clinic and reports new onset of severe low back pain. What action by the nurse is most appropriate?
- A. Assess the client's gait and balance.
- B. Ask the client about the ease of urine flow.
- C. Document the report completely.
- D. Inquire about the client's job risks.
Correct Answer: A
Rationale: Prostate cancer commonly metastasizes to bones, especially the spine, causing spinal cord compression a medical emergency that can lead to paralysis if untreated. New, severe low back pain in this context suggests possible metastasis, making gait and balance assessment the most appropriate action to check for neurological deficits (e.g., weakness, unsteady gait) indicating compression. This prioritizes client safety, as falls or worsening paralysis could result without intervention. Asking about urine flow relates to prostate obstruction, less urgent here given the pain's prominence. Documentation is essential but passive without assessment. Job risks might contribute to back pain but are secondary to cancer history. Assessing gait and balance first ensures rapid escalation if needed, reflecting oncology nursing's focus on detecting metastatic complications early.
A nurse is caring for a client with a history of an abdominal aortic aneurysm. Which of the following assessment findings requires immediate intervention?
- A. Back pain
- B. Absent peripheral pulses
- C. Decreased urine output
- D. Nausea and vomiting
Correct Answer: B
Rationale: An AAA can rupture absent peripheral pulses signal dissection or clot, cutting flow, a surgical emergency needing instant action per ABCs. Back pain hints at expansion, urgent but less acute. Urine drop or nausea follows, not leads. Nurses jump on pulselessness, anticipating OR prep, a life-or-limb save in this ticking vascular bomb.
A 65-year-old male client is brought via EMS to the emergency department with chest pain. He rates the pain as a 10 on a scale from 0-10; the pain is located mid-sternum and radiates to his left arm. His heart rate is 126 beats/minute and blood pressure are 96/60 mm Hg. A 12-lead electrocardiogram is performed and reveals ST-segment elevation. Which of the following interventions does the nurse anticipate performing immediately?
- A. Administer oxygen
- B. Administer morphine
- C. Administer a statin
- D. Administer nitroglycerin
Correct Answer: A
Rationale: ST-elevation MI (STEMI) signals acute coronary occlusion severe chest pain, tachycardia, and hypotension demand oxygen first to counter hypoxia, per ABCs, buying time for reperfusion. Morphine eases pain, nitroglycerin dilates (if BP allows), but oxygen's immediate. Statins aid long-term, not now. Nurses prioritize oxygen, anticipating cath lab prep, a critical step in this time-sensitive infarct emergency.