Nokea
The client diagnosed with exercise-induced asthma (EIA) is being discharged. Which information should the nurse include in the discharge teaching?
- A. Take two (2) puffs on the rescue inhaler and wait five (5) minutes before exercise.
- B. Warm-up exercises will increase the potential for developing the asthma attacks.
- C. Use the bronchodilator inhaler immediately prior to beginning to exercise.
- D. Increase dietary intake of food high in monosodium glutamate (MSG).
Correct Answer: A
Rationale: Two puffs of a rescue inhaler 5 minutes before exercise (A) prevents EIA. Warm-ups (B) reduce attacks, immediate use (C) is less effective, and MSG (D) is a trigger.
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The nurse and an unlicensed assistive personnel (UAP) are caring for a group of clients on a surgical floor. Which information provided by the UAP requires immediate intervention by the nurse?
- A. There is a small, continuous amount of bright-red drainage coming out from under the dressing of the client who had a radical neck dissection.
- B. The client who has had a right upper lobectomy is complaining that the patient-controlled analgesia (PCA) pump is not providing any relief.
- C. The client diagnosed with cancer of the lung is complaining of being tired and short of breath.
- D. The client admitted with chronic obstructive pulmonary disease is making a whistling sound with every breath.
Correct Answer: A
Rationale: Bright-red drainage post-neck dissection (A) suggests hemorrhage, requiring immediate action. PCA failure (B), fatigue/SOB (C), and wheezing (D) are expected or less urgent.
A patient receiving medical treatment for an active tuberculosis infection asks when she can starting going out in public again. You respond that she is no longer contagious when:
- A. She has 3 negative sputum cultures
- B. Her signs and symptoms improve
- C. She has completed the full medication regime
- D. Her chest x-ray is normal
- E. She has been on tuberculosis medications for about 3 weeks
Correct Answer: A
Rationale: A patient with active TB is considered non-contagious after three consecutive negative sputum cultures, indicating no viable bacteria. Symptom improvement, medication duration, or normal X-rays alone do not confirm non-contagiousness.
The nurse observes the client sitting on the side of the bed with the arms propped on the over-bed table. The chest is barrel shaped and the client is breathing though lips spaced close together and is exhaling slowly. Which concept is priority for this client?
- A. Mobility.
- B. Nutrition.
- C. Activity intolerance.
- D. Oxygenation.
Correct Answer: D
Rationale: Tripod position, barrel chest, and pursed-lip breathing (D) indicate COPD with oxygenation as the priority. Mobility (A), nutrition (B), and activity (C) are secondary.
The nurse is caring for a client on a ventilator and the alarm goes off. Which action should the nurse implement first?
- A. Notify the respiratory therapist immediately.
- B. Check the ventilator to determine the cause.
- C. Elevate the head of the client's bed.
- D. Assess the client's oxygen saturation.
Correct Answer: B
Rationale: Checking the ventilator (B) is the first action to identify the alarm’s cause (e.g., disconnection, obstruction), per the ABCs. Notifying the therapist (A) delays intervention. Elevating the bed (C) is irrelevant. Assessing oxygen saturation (D) is secondary to addressing the ventilator issue.
The client diagnosed with influenza A is being discharged from the emergency department with a prescription for antibiotics. Which statement by the client indicates an understanding of this prescription?
- A. These pills will make me feel better fast and I can return to work.
- B. The antibiotics will help prevent me from developing a bacterial pneumonia.
- C. If I had gotten this prescription sooner, I could have prevented this illness.
- D. I need to take these pills until I feel better; then I can stop taking the rest.
Correct Answer: B
Rationale: Antibiotics for influenza (B) prevent secondary bacterial pneumonia, not treat the virus. Quick recovery (A), prevention (C), and stopping early (D) are incorrect.