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The client is suspected of having a pulmonary embolus. Which diagnostic test suggests the presence of a pulmonary embolus and requires further investigation?
- A. Plasma D-dimer test.
- B. Arterial blood gases.
- C. Chest x-ray (CXR).
- D. Magnetic resonance imaging (MRI).
Correct Answer: A
Rationale: Elevated D-dimer (A) suggests clotting, warranting further PE investigation (e.g., CT). ABGs (B) show hypoxia, CXR (C) is nonspecific, and MRI (D) is not standard.
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A patient with severe COPD is having an episode of extreme shortness of breath and requests their inhaler. Which type of inhaler ordered by the physician would provide the FASTEST relief for the patient based on this particular situation?
- A. Spiriva
- B. Salmeterol
- C. Symbicort
- D. Albuterol
Correct Answer: D
Rationale: Albuterol , a short-acting beta-agonist, provides rapid bronchodilation for acute shortness of breath. Spiriva , Salmeterol , and Symbicort are long-acting or combination drugs for maintenance.
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.
When administering oxygen to the client through a partial rebreathing mask, which observation is most important for the nurse to report to the respiratory therapy department?
- A. Moisture is accumulating inside the mask.
- B. The bag collapses during inspiration.
- C. The mask covers the client's mouth and nose.
- D. The strap around the client's head is snug.
Correct Answer: B
Rationale: A collapsing bag during inspiration indicates inadequate oxygen flow, which must be reported to ensure proper oxygen delivery.
Which intervention should the emergency department nurse implement first for the client admitted for an acute asthma attack?
- A. Administer glucocorticoids intravenously.
- B. Administer oxygen 5 L per nasal cannula.
- C. Establish and maintain a 20-gauge saline lock.
- D. Assess breath sounds every 15 minutes.
Correct Answer: B
Rationale: In an acute asthma attack, the priority is to address hypoxia. Administering oxygen (B) ensures adequate oxygenation, which is critical in respiratory distress. IV glucocorticoids (A) reduce inflammation but act slowly and are not the first intervention. Establishing a saline lock (C) is preparatory but not immediate. Assessing breath sounds (D) is important but secondary to ensuring oxygenation.
A farmer who has had a cough for several months has noticed a lack of energy lately. He is being tested for histoplasmosis. Which factor reported by the client would be most related to the diagnosis of histoplasmosis?
- A. He drinks raw milk.
- B. He cleans chicken houses.
- C. He handles fertilizer frequently.
- D. He stepped on a rusty nail recently.
Correct Answer: B
Rationale: Cleaning chicken houses exposes the client to bird droppings, a common source of Histoplasma capsulatum, the fungus causing histoplasmosis.