Nokea
The nurse has given instructions on pursed-lip breathing to a client with COPD. Which statement by the client would indicate effective teaching?
- A. I should inhale through my mouth.'
- B. I should tighten my abdominal muscles with inhalation.'
- C. I should contract my abdominal muscles with exhalation.'
- D. I should make inhalation twice as long as exhalation.'
Correct Answer: C
Rationale: Pursed-lip breathing involves inhaling through the nose and exhaling slowly through pursed lips, which may involve contracting abdominal muscles to assist with exhalation, prolonging exhalation to reduce air trapping in COPD.
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A woman has undergone a mastectomy of her right breast and has been brought to the recovery unit. The nurse explains that the client should
- A. keep her right arm elevated on a pillow.
- B. keep her right arm elevated above her head.
- C. keep her right arm level with the heart.
- D. keep her right arm slightly lower than her heart.
Correct Answer: A
Rationale: Elevating the arm on a pillow reduces lymphedema risk post-mastectomy by promoting lymphatic drainage.
A 9-year-old child weighing 40 kilograms has an order for piperacillin (Pipracil) via IV infusion. The recommended daily dose for this medication is 240-300 mg/kg/day IV div. q8h. What is the maximum daily dose of piperacillin this client can receive per day? Calculate and fill in the blank.
Correct Answer: 12,000 mg
Rationale: Maximum dose: 300 mg/kg/day × 40 kg = 12,000 mg/day.
The nurse is caring for a client with bulimia nervosa. The nurse recognizes that the major difference in the client with anorexia nervosa and the client with bulimia nervosa is the client with bulimia:
- A. Is usually grossly overweight.
- B. Has a distorted body image.
- C. Recognizes that she has an eating disorder.
- D. Struggles with issues of dependence versus independence.
Correct Answer: C
Rationale: Clients with bulimia often recognize their eating disorder, unlike those with anorexia, who may deny the problem due to distorted body image.
The nurse is obtaining a history on a 74-year-old client. Which statement made by the client would alert the nurse to a possible fluid and electrolyte imbalance?
- A. My skin is always so dry.'
- B. I often use a laxative for constipation.'
- C. I have always liked to drink a lot of water.'
- D. I sometimes have a problem with dribbling urine.'
Correct Answer: B
Rationale: Frequent laxative use can cause fluid and electrolyte losses (e.g., potassium, sodium), leading to imbalances, unlike the other statements.
The charge nurse is making assignments for the day. After accepting the assignment to a client with leukemia, the nurse tells the charge nurse that her child has chickenpox. Which initial action should the charge nurse take?
- A. Change the nurse's assignment to another client
- B. Explain to the nurse that there is no risk to the client
- C. Ask the nurse if the chickenpox have scabbed
- D. Ask the nurse if she has ever had the chickenpox
Correct Answer: D
Rationale: Asking if the nurse has had chickenpox determines her immunity, as non-immune nurses risk transmitting varicella to an immunocompromised leukemia patient.