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The nurse is caring for a client with a history of chronic obstructive pulmonary disease who is prescribed fluticasone (Flovent). The nurse should instruct the client to:
- A. Use the inhaler as needed for shortness of breath.
- B. Rinse the mouth after using the inhaler.
- C. Shake the inhaler before use.
- D. Take two puffs twice daily.
Correct Answer: B
Rationale: Rinsing the mouth after using fluticasone prevents oral candidiasis, a common side effect of inhaled corticosteroids.
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A client receiving chemotherapy has a platelet count of 15,000 mm³ (15 x 10â¹/L). Based on this laboratory result, which form of precautions should the nurse implement?
- A. Contact
- B. Bleeding
- C. Respiratory
- D. Neutropenic
Correct Answer: B
Rationale: When the platelet count is less than 20,000 mm³ (20 x 10â¹/L), the client is at risk for bleeding, and the nurse should institute bleeding precautions. Contact precautions are initiated in a client who has drainage from wounds that may be infectious. Respiratory precautions are instituted for a client with a respiratory infection that is transmitted by the airborne route. Neutropenic precautions would be instituted for a client with a low neutrophil count.
A client with a history of cirrhosis is admitted with hepatic encephalopathy. The nurse should include which of the following in the plan of care?
- A. Administer lactulose as prescribed.
- B. Encourage a high-protein diet.
- C. Restrict fluid intake.
- D. Administer sedatives for agitation.
Correct Answer: A
Rationale: Lactulose reduces ammonia levels in hepatic encephalopathy.
A client with a history of stroke is at risk for aspiration. Which of the following interventions should the nurse include in the plan of care? Select all that apply.
- A. Position the client upright during meals.
- B. Offer thin liquids to promote swallowing.
- C. Assess the client's gag reflex before feeding.
- D. Provide small, frequent meals.
- E. Thicken liquids as needed.
Correct Answer: A, C, D, E
Rationale: Upright positioning, assessing gag reflex, small frequent meals, and thickened liquids reduce aspiration risk. Thin liquids increase risk.
The nurse is auscultating the lung sounds of a client with long-standing emphysema. The nurse should determine if the client has?
- A. Fine crackles
- B. Diminished breath sounds
- C. Stridor
- D. Pleural friction rub
Correct Answer: B
Rationale: Diminished breath sounds are typical in emphysema due to air trapping and reduced airflow. Crackles, stridor, and pleural friction rubs are associated with other conditions.
Conflicts, according to Lewin, include which types of conflict? Select all that apply.
- A. Conceptualization conflicts
- B. Avoidance - Avoidance conflicts
- C. Approach - Approach conflicts
- D. Resolvable conflicts
- E. Unresolvable conflicts
- F. Double Approach - Avoidance conflicts
- G. Approach-Avoidance conflicts
Correct Answer: B,C,F,G
Rationale: According to Lewin's conflict theory, the types of conflict include Avoidance-Avoidance , Approach-Approach , Double Approach-Avoidance (F), and Approach-Avoidance (G). Conceptualization, resolvable, and unresolvable conflicts are not part of Lewin's framework.