Nokea
The client diagnosed with cancer of the larynx has had four (4) weeks of radiation therapy to the neck. The client is complaining of severe pain when swallowing. Which scientific rationale explains the pain?
- A. The cancer has grown to obstruct the esophagus.
- B. The treatments are working on the cancer and the throat is edematous.
- C. Cancers are painful and this is expected.
- D. The treatments are also affecting the esophagus, causing ulcerations.
Correct Answer: D
Rationale: Radiation causes esophageal mucositis/ulcerations (D), leading to painful swallowing. Obstruction (A), edema (B), and cancer pain (C) are less likely causes.
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The charge nurse receives morning laboratory and respiratory data on the clients. Which data requires immediate intervention?
- A. ABG results of pH 7.35, Paco2 56, Hco3 29, Pao2 78 for a client diagnosed with COPD.
- B. Pulse oximetry reading of 89% on a two-day postsurgical total knee replacement client.
- C. Hgb of 9 g/dL and Hct of 28% on a client who is receiving the second unit of blood.
- D. B-type natriuretic peptide (BNP) of 100 on a client diagnosed with stage 4 congestive heart failure.
Correct Answer: B
Rationale: SpO2 89% post
Other than obtaining a vaccination against influenza, which nursing advice is most helpful to high-risk clients who want to avoid getting influenza?
- A. Consume adequate vitamin C.
- B. Avoid crowded places.
- C. Dress warmly in cold weather.
- D. Reduce daily stress and anxiety.
Correct Answer: B
Rationale: Avoiding crowded places reduces exposure to influenza, a highly contagious respiratory virus.
Which instruction is priority for the nurse to discuss with the client diagnosed with ARDS who is being discharged from the hospital?
- A. Avoid smoking and exposure to smoke.
- B. Do not receive flu or pneumonia vaccines.
- C. Avoid any type of alcohol intake.
- D. It will take about one (1) month to recuperate.
Correct Answer: A
Rationale: Avoiding smoke (A) prevents further lung damage, a priority post-ARDS. Vaccines (B) are recommended, alcohol (C) is not restricted, and recovery time (D) varies.
A 62-year-old man is admitted with emphysema and acute upper respiratory infection. Oxygen is ordered at 2 L/min. The reason for low-flow oxygen is to:
- A. prevent excessive drying of secretions.
- B. facilitate oxygen diffusion of the blood.
- C. prevent depression of the respiratory drive.
- D. compensate for increased airway resistance.
Correct Answer: C
Rationale: In COPD, low oxygen levels drive respiration. Low-flow oxygen prevents suppression of the respiratory drive, which could occur with high-flow oxygen.
A 25 year-old female patient with pneumonia is prescribed Doxycycline. What question is important to ask the patient prior to administration of this medication?
- A. Do you take birth control pills?'
- B. Are you allergic to Penicillin?'
- C. Are you allergic to eggs?'
- D. Do you have a history of diabetes?'
Correct Answer: A
Rationale: Doxycycline can reduce the effectiveness of oral contraceptives, so asking about birth control use is critical. Penicillin allergy is unrelated, egg allergy is relevant for vaccines, and diabetes is not a primary concern.