Nokea
The client diagnosed with lung cancer has been told the cancer has metastasized to the brain. Which intervention should the nurse implement?
- A. Discuss implementing an advance directive.
- B. Explain the use of chemotherapy for brain involvement.
- C. Teach the client to discontinue driving.
- D. Have the significant other make decisions for the client.
Correct Answer: C
Rationale: Brain metastasis impairs cognition, making driving unsafe (C). Advance directives (A), chemotherapy (B), and proxy decisions (D) are secondary or inappropriate.
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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.
You're teaching a group of long-term care health givers about the signs and symptoms of tuberculosis. What signs and symptoms will you include in your education?
- A. Cough for a minimum of 6 weeks
- B. Night sweats
- C. Weight gain
- D. Hemoptysis
- E. Chills
- F. Fever
- G. Chest pain
Correct Answer: B,D,E,F,G
Rationale: Tuberculosis symptoms include night sweats , hemoptysis , chills , fever , and chest pain (G). A cough typically lasts 3 weeks or more, not necessarily 6 weeks (not A). Weight loss, not weight gain , is common.
A 55-year old male patient is admitted with an active tuberculosis infection. The nurse will place the patient in precautions and will always wear when providing patient care?
- A. droplet, respirator
- B. airborne, respirator
- C. contact and airborne, surgical mask
- D. droplet, surgical mask
Correct Answer: B
Rationale: A patient with ACTIVE TB is contagious. The bacterium, mycobacterium tuberculosis which causes TB, is so small that it can stay suspended in the air for hours to days. Therefore, the nurse will place the patient in AIRBORNE precautions. In addition, a special mask must be worn called a respirator (as referred to as an N95 mask.....a surgical mask does NOT work with this condition).
You're providing discharge teaching to a patient who was admitted for pneumonia. You are discussing measures the patient can take to prevent pneumonia. Which of the following statements by the patient indicates they did NOT understand your education material?
- A. I'll use hand sanitizer regularly while I'm out in public.'
- B. It is important I don't receive the Pneumovax vaccine since I'm already immune to pneumonia.'
- C. I will try to avoid large crowds of people during the peak of flu season.'
- D. It is important I try to quit smoking.'
Correct Answer: B
Rationale: The statement about not receiving the Pneumovax vaccine is incorrect, as vaccination is recommended to prevent pneumococcal pneumonia, and prior infection doesn't confer immunity. Other options reflect correct preventive measures.
In regards to question 10, which action by the patient demonstrates they know how to properly use this medication?
- A. The patient rinses their mouth after using the Spiriva inhaler.
- B. The patient rinses their mouth after using the Pulmicort inhaler.
- C. The patient dispenses of the inhalers.
- D. The patient coughs 2 times after using the Pulmicort inhaler.
Correct Answer: B
Rationale: Pulmicort (corticosteroid) requires mouth rinsing to prevent oral thrush. Spiriva doesn't require rinsing, and coughing or disposing are incorrect.