Nokea
The COPD patient delightedly tells the nurse that he has quit smoking and is using chewing tobacco. The nurse's best intervention would be to:
- A. Congratulate him on his quitting smoking.
- B. Warn him of the dangers of oral cancer.
- C. Suggest that he add nicotine patches in addition to the chewing tobacco.
- D. Point out that he is still addicted and is using tobacco.
Correct Answer: D
Rationale: The correct answer is D. The nurse should point out that the patient is still addicted and using tobacco. This is important because quitting smoking is a positive step, but using chewing tobacco still poses health risks. By highlighting the addiction and continued use of tobacco, the nurse can provide necessary education and support for the patient's overall health.
Choice A is incorrect because it fails to address the continued tobacco use. Choice B is also incorrect as it focuses on a specific risk (oral cancer) rather than the broader issue of tobacco addiction. Choice C is incorrect as adding nicotine patches would not address the fact that the patient is still using tobacco in another form.
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A nurse cares for a client who had a bronchoscopy 2 hours ago. The client asks for a drink of water. Which action should the nurse take next?
- A. Call the physician and request a prescription for food and water.
- B. Provide the client with ice chips instead of a drink of water.
- C. Assess the client's gag reflex before giving any food or water.
- D. Let the client have a small sip to see whether he or she can swallow.
Correct Answer: C
Rationale: Correct Answer: C
Rationale:
1. Assessing the client's gag reflex is crucial after a bronchoscopy to prevent aspiration.
2. Gag reflex helps protect the airway from foreign substances entering the lungs.
3. Providing food or water without assessing the gag reflex can lead to aspiration pneumonia.
4. It is essential to ensure the client's safety before allowing any intake post-bronchoscopy.
Summary:
A: Calling the physician for a prescription is not necessary at this immediate stage.
B: Ice chips may still pose a risk if the client cannot protect their airway.
D: Allowing a sip without assessing gag reflex may lead to aspiration.
Two days after undergoing pelvic surgery, a patient develops marked dyspnea and anxiety. What is the first action that the nurse should take?
- A. Raise the head of the bed.
- B. Notify the health care provider.
- C. Take the patient’s pulse and blood pressure.
- D. Determine the patient’s SpO with an oximeter.
Correct Answer: B
Rationale: In this situation, the priority action should be to notify the healthcare provider as the patient's symptoms could indicate a serious complication post-surgery. The healthcare provider needs to be informed promptly to assess and provide appropriate interventions.
A client is receiving oxygen at 4 L per nasal cannula. What comfort measure may the nurse delegate to assistive personnel (AP)?
- A. Apply water-soluble ointment to nares and lips.
- B. Periodically turn the oxygen down or off.
- C. Replaces the oxygen tubing with a different type.
- D. Turn the client every 2 hours or as needed.
Correct Answer: A
Rationale: The correct answer is A because applying water-soluble ointment to nares and lips helps prevent skin breakdown and discomfort caused by the oxygen flow. This task is within the scope of practice for assistive personnel (AP) as it does not require specialized medical knowledge or training.
Choice B is incorrect because adjusting oxygen flow should only be done by licensed healthcare providers based on the client's prescribed oxygen therapy. Choice C is incorrect as replacing oxygen tubing requires knowledge of oxygen delivery systems and potential risks associated with incorrect tubing selection. Choice D is incorrect because turning the client every 2 hours is a nursing intervention related to preventing pressure ulcers, not specifically related to oxygen therapy comfort measures.
All of the following states decrease lung compliance EXCEPT
- A. Lung fibrosis
- B. Increased pulmonary venous pressure
- C. Long period of time where the lung is unventilated
- D. Emphysema
Correct Answer: D
Rationale: The correct answer is D: Emphysema. Emphysema is characterized by destruction of lung tissue, leading to loss of elasticity and increased compliance. Increased compliance means the lungs are easier to expand, contrary to decreased compliance seen in the other conditions listed. Lung fibrosis, increased pulmonary venous pressure, and prolonged lung collapse all lead to decreased lung compliance by causing stiffness, fluid accumulation, and reduced lung expansion, respectively. Therefore, D is the correct answer as it does not decrease lung compliance.
The term hypercapnia refers to
- A. the cessation of breathing
- B. elevated PCO2
- C. elevated PO2
- D. an increase in pH
Correct Answer: B
Rationale: Step 1: Understand the term - Hypercapnia means increased levels of CO2 in the blood.
Step 2: Elevated PCO2 directly relates to increased CO2 levels.
Step 3: This condition can lead to respiratory issues due to excess CO2.
Step 4: Therefore, choice B, elevated PCO2, is the correct answer.
Summary: Choices A, C, and D are incorrect as hypercapnia specifically refers to increased CO2 levels, not the cessation of breathing, elevated PO2, or an increase in pH.