Nokea
The family of a neutropenic client reports that the client is confused and 'is not acting right.' What action by the nurse is the priority?
- A. Delegate taking a set of vital signs
- B. Ask the client about pain
- C. Look at today's laboratory results
- D. Assess the client for a urinary tract infection
Correct Answer: A
Rationale: Neutropenia slashes immunity confusion screams infection, like sepsis, needing instant vitals to catch fever or shock, a priority delegated to flag danger fast per ABCs. Pain's a clue, but vitals trump. Labs lag; UTI assessment follows. Nurses lean on teamwork, ensuring rapid data in this infection-prone fog, a life-saving first step.
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Risk factors for developing COPD include:
- A. Seasonal respiratory conditions and family history of emphysema
- B. Age, high fat diet and sedentary lifestyle
- C. History of cardiovascular and autoimmune conditions
- D. Indoor and outdoor air pollution
Correct Answer: D
Rationale: COPD risk factors center on chronic airway damage. Seasonal respiratory conditions may exacerbate, not cause, COPD, though family history of emphysema suggests genetic risk (e.g., alpha-1 antitrypsin deficiency), but it's less primary than exposure. Age is a factor as lung function declines naturally, but high fat diet and sedentary lifestyle are more linked to obesity or cardiovascular disease, not directly COPD. Cardiovascular and autoimmune histories don't drive COPD etiology smoking and pollution do. Indoor (e.g., biomass smoke) and outdoor air pollution (e.g., particulates) are major irritants, causing inflammation and irreversible airflow limitation, per Deravin and Anderson (2019). Pollution's role is critical globally, especially in occupational or urban settings, outweighing secondary factors by directly triggering the chronic inflammatory cascade defining COPD pathogenesis.
In order to provide optimal management and prevent deterioration, the patient needs to be educated in selfmanagement of their condition. Which of the following are not elements of self-management?
- A. Engaging in activities that promote health
- B. Managing COPD by monitoring signs and symptoms
- C. Weekly visits with the medical practitioner
- D. Following a treatment plan
Correct Answer: C
Rationale: COPD self-care health habits, symptom checks, plan adherence empowers patients. Weekly doc visits? Overkill, not core self-management cuts reliance. Nurses teach this, a chronic autonomy boost.
Insulin is an anabolic hormone. Question: A catabolic state induced by insulin deficiency has an effect on which metabolism?
- A. Protein metabolism
- B. Glucose metabolism
- C. Fat metabolism
- D. A+B+C
Correct Answer: D
Rationale: Insulin gone, catabolism rages proteins break, glucose spikes, fats burn all unravel. No picking one; it's a full-body crash nurses see this in type 1's ketosis, a chronic fuel flip.
With regards to adverse effects of first-line antihypertensive medications, angioedema has been associated with which ONE of the following classes of antihypertensives?
- A. Angiotensin receptor blockers
- B. Angiotensin-converting enzyme inhibitors
- C. Calcium channel blockers (dihydropyridine)
- D. Thiazide diuretics
Correct Answer: B
Rationale: Angioedema, a potentially life-threatening swelling of deep skin layers or mucous membranes, is a well-documented adverse effect of angiotensin-converting enzyme (ACE) inhibitors, occurring in about 0.1-0.7% of patients due to bradykinin accumulation from enzyme inhibition. This distinguishes ACE inhibitors from other first-line antihypertensives. Angiotensin receptor blockers (ARBs) rarely cause angioedema, as they don't affect bradykinin levels. Calcium channel blockers (e.g., dihydropyridines like amlodipine) may cause peripheral edema but not angioedema. Thiazide diuretics are linked to electrolyte imbalances or rashes, not angioedema. Family physicians must recognize this ACE inhibitor risk, ensuring prompt discontinuation and airway management if it occurs, critical for safe chronic disease management.
A nurse is caring for a client diagnosed with polycythemia vera. Which of the following should the nurse include in the client and family education?
- A. Resume normal activity
- B. Wear support hose while awake
- C. Decrease fluid intake to no more than 1 liter per day
- D. Diet high in vitamin K intake
Correct Answer: B
Rationale: Polycythemia vera thickens blood, slowing venous return support hose boost circulation, cutting clot risk, a practical teaching point for clients and families. Normal activity's fine but misses prevention. Less fluid thickens blood further, dangerous here; high vitamin K aids clotting, counterproductive. Nurses push hose use, easing symptoms like swelling, a key strategy in managing this hyperviscous state.