Nokea
The nurse is working in the emergency department and has four clients arrive at the same time. Which client should the nurse see first?
- A. A client requesting antibiotics for a cough
- B. A client who has a facial fracture with severe facial and oral swelling
- C. A client who states she has not urinated in 8 hours
- D. A client with a history of chronic obstructive pulmonary disease reporting increased dyspnea
Correct Answer: B
Rationale: Facial fracture with severe swelling risks airway ABCs dictate first look, as edema could choke breathing fast. Cough's stable, anuria's concerning but not immediate, COPD dyspnea's chronic unless crashing. Nurses triage swelling, anticipating intubation, a split-second save in this ED rush.
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The family of a neutropenic client reports that the client is confused and 'is not acting right.' What action by the nurse is the priority?
- A. Delegate taking a set of vital signs
- B. Ask the client about pain
- C. Look at today's laboratory results
- D. Assess the client for a urinary tract infection
Correct Answer: A
Rationale: Neutropenia slashes immunity confusion screams infection, like sepsis, needing instant vitals to catch fever or shock, a priority delegated to flag danger fast per ABCs. Pain's a clue, but vitals trump. Labs lag; UTI assessment follows. Nurses lean on teamwork, ensuring rapid data in this infection-prone fog, a life-saving first step.
A nurse is providing discharge teaching to a client who recently underwent a mechanical valve replacement. Which of the following statements by the client indicates the clients correct understanding of the discharge teaching regarding warfarin anticoagulant therapy?
- A. I may need to modify my diet while on this medication
- B. I do not need to take my prescribed medication for the rest of my life
- C. Additional monitoring is not required while on the anticoagulant
- D. I can lead a normal life while on anticoagulants; no restrictions are required
Correct Answer: A
Rationale: Mechanical valves demand warfarin forever diet tweaks, like steady vitamin K, keep INR stable, a sign the client gets it. Lifelong meds, monitoring, and restrictions (e.g., bleeding risk) are non-negotiable. Nurses cheer this dietary nod, ensuring warfarin's tightrope walk succeeds, a smart grasp in this valve swap life.
In infective endocarditis
- A. oslers nodes are tender
- B. Janeway lesions are tender
- C. Right ventricular MI is more likely to be acute than subacute
- D. A+C
Correct Answer: A
Rationale: Endocarditis Osler's nodes hurt, Janeway's don't, right heart's acute in IVDU. Nurses feel this chronic pain clue.
Risk factors for developing COPD include:
- A. Seasonal respiratory conditions and family history of emphysema
- B. Age, high fat diet and sedentary lifestyle
- C. History of cardiovascular and autoimmune conditions
- D. Indoor and outdoor air pollution
Correct Answer: D
Rationale: COPD risk factors center on chronic airway damage. Seasonal respiratory conditions may exacerbate, not cause, COPD, though family history of emphysema suggests genetic risk (e.g., alpha-1 antitrypsin deficiency), but it's less primary than exposure. Age is a factor as lung function declines naturally, but high fat diet and sedentary lifestyle are more linked to obesity or cardiovascular disease, not directly COPD. Cardiovascular and autoimmune histories don't drive COPD etiology smoking and pollution do. Indoor (e.g., biomass smoke) and outdoor air pollution (e.g., particulates) are major irritants, causing inflammation and irreversible airflow limitation, per Deravin and Anderson (2019). Pollution's role is critical globally, especially in occupational or urban settings, outweighing secondary factors by directly triggering the chronic inflammatory cascade defining COPD pathogenesis.
The public health nurse is presenting a health-promotion class to a group at a local community center. Which intervention most directly addresses the leading cause of cancer deaths in North America?
- A. Monthly self-breast exams
- B. Smoking cessation
- C. Annual colonoscopies
- D. Monthly testicular exams
Correct Answer: B
Rationale: Lung cancer tops the list of cancer deaths in North America for both men and women, as noted in the feedback, with over 570,000 deaths projected in 2011 alone. Smoking is the primary risk factor for lung cancer, making cessation the most direct intervention to tackle this killer. Self-breast and testicular exams target breast and testicular cancers, respectively, which rank lower in mortality (breast is second for women, prostate second for men). Colonoscopies address colorectal cancer, third in frequency, but lung cancer's dominance ties directly to smoking's prevalence. By pushing cessation, nurses hit the root cause head-on, reducing exposure to carcinogens like tar and nicotine that drive malignant transformation in lung tissue. This aligns with primary prevention, cutting incidence before it starts, unlike screening which catches disease later.