Nokea
The nurse is caring for a patient with cystic fibrosis (CF) and understands that treatment consists of which of the following? (Select all that apply.)
- A. Airway clearance therapies
- B. Antibiotic therapy
- C. Nutritional support
- D. Tracheostomy
Correct Answer: A
Rationale: The correct answer is A: Airway clearance therapies. In cystic fibrosis (CF), mucus buildup in the lungs can lead to infections and breathing difficulties. Airway clearance therapies help loosen and clear this mucus, improving lung function. Antibiotic therapy (B) is used to treat infections but is not specific to CF treatment. Nutritional support (C) is crucial in CF due to malabsorption, but it is not the primary treatment. Tracheostomy (D) is a surgical procedure to create an airway bypassing the upper respiratory tract and is not a standard treatment for CF.
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Acute kidney injury from postrenal etiology is caused by
- A. obstruction of the flow of urine.
- B. conditions that interfere with renal perfusion.
- C. hypovolemia or decreased cardiac output.
- D. conditions that act directly on functioning kidney tissue.
Correct Answer: A
Rationale: The correct answer is A because postrenal acute kidney injury is caused by obstruction of urine flow, leading to pressure build-up in the kidneys and subsequent damage. Obstructions can be due to conditions such as kidney stones, tumors, or enlarged prostate. Choices B, C, and D are incorrect as they relate to pre-renal and intrinsic renal causes of acute kidney injury, not specifically postrenal obstruction. B refers to decreased blood flow to the kidneys, C to low volume or poor heart function affecting kidney perfusion, and D to direct damage to kidney tissue, which do not characterize postrenal etiology.
What diagnostic procedure is required to make a definitive diagnosis of pulmonary embolism?
- A. Arterial blood gas (ABG) analysis.
- B. Chest x-ray examination.
- C. High resolution multidetector CT angiogram.
- D. Ventilation-perfusion scanning.
Correct Answer: C
Rationale: The correct answer is C: High resolution multidetector CT angiogram. This diagnostic procedure is required for a definitive diagnosis of pulmonary embolism because it provides detailed imaging of the pulmonary vasculature, allowing visualization of blood clots in the pulmonary arteries.
A: Arterial blood gas (ABG) analysis does not directly diagnose pulmonary embolism but may show signs of hypoxemia or respiratory alkalosis, which can be seen in some cases of pulmonary embolism.
B: Chest x-ray examination may show nonspecific findings such as atelectasis or pleural effusion but cannot definitively diagnose pulmonary embolism.
D: Ventilation-perfusion scanning is another imaging modality used in the diagnosis of pulmonary embolism, but it is less commonly used compared to CT angiogram due to lower sensitivity and specificity.
The nurse plans a teaching session with a client but postpones the planned session based on which nursing problem?
- A. Knowledge deficit regarding impending surgery.
- B. Ineffective management of treatment regimen.
- C. Activity intolerance related to postoperative pain.
- D. Noncompliance with prescribed exercise plan.
Correct Answer: C
Rationale: Step-by-step rationale for choice C:
1. Activity intolerance is a priority nursing problem postoperatively due to pain.
2. Postoperative pain can limit the client's ability to perform activities.
3. Addressing activity intolerance is crucial for promoting recovery and preventing complications.
4. Delaying the teaching session helps the nurse focus on managing pain first.
Summary of why other choices are incorrect:
- Choice A: Knowledge deficit can be addressed after managing immediate postoperative issues.
- Choice B: Treatment regimen management is important but may not be as urgent as addressing activity intolerance related to pain.
- Choice D: Noncompliance with exercise plan can be addressed once the client's pain and activity intolerance are under control.
A young adult patient with metastatic cancer, who is very close to death, appears restless. The patient keeps repeating, 'I am not ready to die.' Which action is best for the nurse to take?
- A. Remind the patient that no one feels ready for death.
- B. Sit at the bedside and ask if there is anything the patient needs.
- C. Insist that family members remain at the bedside with the patient.
- D. Tell the patient that everything possible is being done to delay death.
Correct Answer: B
Rationale: The correct answer is B because sitting at the bedside and asking if there is anything the patient needs demonstrates empathy and support. It allows the patient to express their concerns and fears, providing emotional comfort. It shows the nurse is actively listening and willing to help address any immediate needs or concerns.
Choice A is incorrect because it dismisses the patient's feelings and may come across as invalidating. Choice C is incorrect because insisting that family members remain may not be what the patient needs at that moment and could cause additional stress. Choice D is incorrect because it does not address the patient's emotional distress and may not be true in the context of terminal illness.
The patient is in need of immediate hemodialysis, but has no vascular access. The nurse prepares the patient for insertion of
- A. a percutaneous catheter at the bedside.
- B. a percutaneous tunneled catheter at the bedside.
- C. an arteriovenous fistula.
- D. an arteriovenous graft.
Correct Answer: A
Rationale: The correct answer is A: a percutaneous catheter at the bedside. This is the most appropriate option for immediate hemodialysis when the patient has no vascular access. A percutaneous catheter can be quickly inserted at the bedside, allowing for immediate initiation of hemodialysis.
Choice B, a percutaneous tunneled catheter, involves a more complex insertion process and is not typically done at the bedside. Choices C and D, arteriovenous fistula and arteriovenous graft, require advanced planning and surgical procedures, making them unsuitable for immediate hemodialysis in this scenario.