Nokea
The nurse is performing an occupational history as part of the respiratory assessment. Which occupation(s) place the patient isn't at increased risk for an occupational lung disorder?
- A. A firefighter
- B. A cotton gin worker
- C. A construction contractor
- D. A bartender
Correct Answer: D
Rationale: The correct answer is D: A bartender. Bartenders are not typically exposed to occupational lung hazards like smoke, dust, or chemicals. Firefighters (A), cotton gin workers (B), and construction contractors (C) are all at increased risk due to exposure to smoke, cotton dust, and construction materials, respectively. As a result, the bartender is the least likely to develop an occupational lung disorder compared to the other professions listed.
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The nurse is developing a teaching plan for a 64-year-old client with coronary artery disease (CAD). Which factor should the nurse focus on during the teaching session?
- A. Family history of coronary artery disease
- B. Elevated low-density lipoprotein (LDL) level
- C. Greater risk associated with the patient's gender
- D. Increased risk of cardiovascular disease with aging
Correct Answer: B
Rationale: The correct answer is B: Elevated low-density lipoprotein (LDL) level. This is the most relevant factor to focus on during the teaching session for a client with CAD. Elevated LDL levels are a major risk factor for the development and progression of CAD. By addressing this factor, the nurse can educate the client on the importance of managing cholesterol levels through diet, exercise, and medication.
Incorrect choices:
A: Family history of CAD - While family history is a risk factor, it cannot be modified through education alone.
C: Greater risk associated with the patient's gender - Gender is a non-modifiable risk factor and not the primary focus for teaching.
D: Increased risk of cardiovascular disease with aging - While age is a risk factor, the focus should be on modifiable risk factors like LDL levels.
A nurse is caring for an older adult client who has a pulmonary infection. Which action should the nurse take first?
- A. Encourage the client to increase fluid intake.
- B. Assess the client's level of consciousness.
- C. Raise the head of the bed to at least 45 degrees.
- D. Provide the client with humidified oxygen.
Correct Answer: B
Rationale: The correct action for the nurse to take first is to assess the client's level of consciousness (Choice B) because it is essential to determine the client's current neurological status and mental acuity, which can indicate the severity of the infection and the need for immediate interventions. Assessing consciousness helps in identifying any signs of respiratory distress or potential complications. Encouraging fluid intake (Choice A) is important but not the priority when the client's respiratory status is uncertain. Raising the head of the bed (Choice C) is beneficial for improving oxygenation but should come after assessing the client's consciousness. Providing humidified oxygen (Choice D) is important for respiratory support but should be based on the assessment findings.
Sputum specimens are examined to detect which of the following?
- A. Foreign bodies
- B. Cancer cells
- C. Pulmonary emboli
- D. Inflammation
Correct Answer: B
Rationale: The correct answer is B. Sputum specimens are often examined for cancer cells in cases of suspected lung cancer. While foreign bodies (A) can sometimes be identified, they are less common in routine sputum analysis. Pulmonary emboli (C) cannot be detected via sputum examination; imaging studies are required. Inflammation (D) may be inferred from white blood cell counts, but detecting cancer cells is more specific and clinically significant.
The nurse supervises unlicensed assistive personnel (UAP) providing care for a client who has right lower lobe pneumonia. Which action by the UAP requires the nurse to intervene?
- A. UAP assists the client to ambulate to the bathroom.
- B. UAP helps splint the client's chest during coughing.
- C. UAP transfers the client to a bedside chair for meals.
- D. UAP lowers the head of the client's bed to 15 degrees
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. In right lower lobe pneumonia, positioning the client with the affected side down helps improve ventilation and drainage.
2. Lowering the head of the bed to 15 degrees promotes pooling of secretions, worsening respiratory status.
3. A, B, and C are appropriate actions that promote client comfort and safety in pneumonia management.
4. Intervening in option D is crucial to prevent complications and promote effective respiratory care.
Priority Decision: To reduce the risk for most occupational lung diseases, what is the most important measure the occupational nurse should promote?
- A. Maintaining smoke-free work environments for all employees.
- B. Using masks and effective ventilation systems to reduce exposure to irritants.
- C. Inspection and monitoring of workplaces by national occupational safety agencies.
- D. Requiring periodic chest x-rays and pulmonary function tests for exposed employees.
Correct Answer: D
Rationale: Requiring periodic chest x-rays and pulmonary function tests for exposed employees is crucial in early detection and prevention of occupational lung diseases.