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The charge nurse is making client assignments on a medical floor. Which client should the charge nurse assign to the licensed practical nurse (LPN)?
- A. The client with pneumonia who has a pulse oximeter reading of 91%.
- B. The client with a hemothorax who has Hb of 9 g/dL and Hct of 20%.
- C. The client with chest tubes who has jugular vein distention and BP of 96/60.
- D. The client who is two (2) hours post-bronchoscopy procedure.
Correct Answer: D
Rationale: Post-bronchoscopy (D) is stable for LPN care. Hypoxia (A), anemia (B), and JVD/hypotension (C) require RN assessment.
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A client who had a laryngectomy is nearly ready for discharge. Which instruction is most appropriate for the nurse to give?
- A. Always be sure you have a buddy with you when you go swimming or boating.'
- B. You may take a tub bath, but you should not take a shower.'
- C. Be sure to have only liquids for another three weeks.'
- D. Never cover your stoma with anything.'
Correct Answer: A
Rationale: A buddy is essential during swimming or boating to ensure safety, as water entering the stoma can cause aspiration.
The nurse is assessing a 79-year-old client diagnosed with pneumonia. Which signs and symptoms should the nurse expect to assess in the client?
- A. Confusion and lethargy.
- B. High fever and chills.
- C. Frothy sputum and edema.
- D. Bradypnea and jugular vein distention.
Correct Answer: A
Rationale: Elderly pneumonia patients often present with confusion/lethargy (A) due to hypoxia. Fever/chills (B) are less common in the elderly, frothy sputum/edema (C) suggest heart failure, and bradypnea/JVD (D) are unrelated.
The nurse observes the unlicensed assistive personnel (UAP) removing the nasal cannula from the client diagnosed with COPD while ambulating the client to the bathroom. Which action should the nurse implement?
- A. Praise the UAP because this prevents the client from tripping on the oxygen tubing.
- B. Place the oxygen back on the client while sitting in the bathroom and say nothing.
- C. Explain to the UAP in front of the client oxygen must be left in place at all times.
- D. Discuss the UAP's action with the charge nurse so appropriate action can be taken.
Correct Answer: B
Rationale: COPD clients need continuous oxygen; replacing it (B) corrects the error safely. Praising (A) is incorrect, explaining in front of client (C) is unprofessional, and escalating (D) is premature.
Which household measurement should the nurse use when teaching the client how to self-administer the prescribed amount of liquid cough syrup?
- A. One ounce
- B. One tablespoon
- C. One teaspoon
- D. One capful
Correct Answer: C
Rationale: A 5 mL dose of liquid cough syrup is equivalent to one teaspoon, a standard household measurement.
A patient is admitted with pneumonia. Sputum cultures show that the patient is infected with a gram positive bacterium. The patient is allergic to Penicillin. Which medication would the patient most likely be prescribed?
- A. Macrolide
- B. Cephalosporins
- C. Pencillin G
- D. Tamiflu
Correct Answer: A
Rationale: For gram-positive bacterial pneumonia in a penicillin-allergic patient, macrolides like azithromycin are commonly prescribed due to their efficacy and safety. Cephalosporins may cross-react with penicillin allergies, Penicillin G is contraindicated, and Tamiflu is for viral infections.