Nokea
The nurse is taking the social history from a client diagnosed with small cell carcinoma of the lung. Which information is significant for this disease?
- A. The client worked with asbestos for a short time many years ago.
- B. The client has no family history for this type of lung cancer.
- C. The client has numerous tattoos covering both upper and lower arms.
- D. The client has smoked two (2) packs of cigarettes a day for 20 years.
Correct Answer: D
Rationale: Smoking (D) (40 pack-years) is the primary risk factor for small cell lung cancer. Asbestos (A) is a risk but less significant, family history (B) is irrelevant, and tattoos (C) are unrelated.
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The nurse is assessing a 79-year-old client diagnosed with pneumonia. Which signs and symptoms should the nurse expect to assess in the client?
- A. Confusion and lethargy.
- B. High fever and chills.
- C. Frothy sputum and edema.
- D. Bradypnea and jugular vein distention.
Correct Answer: A
Rationale: Elderly pneumonia patients often present with confusion/lethargy (A) due to hypoxia. Fever/chills (B) are less common in the elderly, frothy sputum/edema (C) suggest heart failure, and bradypnea/JVD (D) are unrelated.
The client admitted for recurrent aspiration pneumonia is at risk for bronchiectasis. Which intervention should the nurse anticipate the health-care provider to order?
- A. Administer intravenous antibiotics for seven (7) days.
- B. Insert a subclavian line and initiate total parenteral nutrition.
- C. Provide a low-calorie and low-sodium restricted diet.
- D. Encourage the client to turn, cough, and deep breathe frequently.
Correct Answer: D
Rationale: Recurrent aspiration pneumonia predisposes to bronchiectasis due to chronic airway damage. Turning, coughing, and deep breathing (D) prevent secretion stasis and further infections. Antibiotics (A) treat active infection, not prevention. TPN (B) is for malnutrition, not directly related. Dietary restrictions (C) are irrelevant.
The client diagnosed with exercise-induced asthma (EIA) is being discharged. Which information should the nurse include in the discharge teaching?
- A. Take two (2) puffs on the rescue inhaler and wait five (5) minutes before exercise.
- B. Warm-up exercises will increase the potential for developing the asthma attacks.
- C. Use the bronchodilator inhaler immediately prior to beginning to exercise.
- D. Increase dietary intake of food high in monosodium glutamate (MSG).
Correct Answer: A
Rationale: Two puffs of a rescue inhaler 5 minutes before exercise (A) prevents EIA. Warm-ups (B) reduce attacks, immediate use (C) is less effective, and MSG (D) is a trigger.
The HCP has recommended a total laryngectomy for a male client diagnosed with cancer of the larynx but the client refuses. Which intervention by the nurse illustrates the ethical principle of nonmalfeasance?
- A. The nurse listens to the client explain why he is refusing surgery.
- B. The nurse and significant other insist that the client have the surgery.
- C. The nurse refers the client to a counselor for help with the decision.
- D. The nurse asks a cancer survivor to come and discuss the surgery with the client.
Correct Answer: A
Rationale: Listening to the client’s reasons (A) respects autonomy and avoids harm (nonmalfeasance). Insisting (B), counseling (C), and survivor talks (D) may pressure or influence unduly.
The nurse is caring for the client diagnosed with ARDS. Which interventions should the nurse implement? Select all that apply.
- A. Assess the client's level of consciousness.
- B. Monitor urine output every shift.
- C. Turn the client every two (2) hours.
- D. Maintain intravenous fluids as ordered.
- E. Place the client in the Fowler's position.
Correct Answer: A,C,D,E
Rationale: LOC assessment (A), turning (C), IV fluids (D), and Fowler’s position (E) support ARDS care. Urine output (B) should be monitored hourly, not per shift.