Nokea
The nurse notices that a client with Parkinson's disease is coughing frequently when eating. Which one of the following interventions should the nurse consider?
- A. Have the client hyperextend the neck when swallowing.
- B. Tell the client to place the chin firmly against the chest when eating.
- C. Thicken all liquids before offering to the client.
- D. Place the client on a clear liquid diet.
Correct Answer: C
Rationale: Thickening liquids reduces aspiration risk in Parkinson's patients with dysphagia, as coughing indicates swallowing difficulty. Hyperextending the neck or a clear liquid diet increases aspiration risk, and chin tuck is less universally effective.
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Which of the following is an expected outcome of pursed-lip breathing for clients with emphysema?
- A. To promote oxygen intake.
- B. To strengthen the diaphragm.
- C. To strengthen the intercostal muscles.
- D. To promote carbon dioxide elimination.
Correct Answer: D
Rationale: Pursed-lip breathing prolongs exhalation, reducing air trapping and promoting CO2 elimination in emphysema. It does not directly increase oxygen intake or strengthen muscles.
Which of the following medications would be appropriate for the treatment of an allergic reaction to a blood transfusion? Select all that apply.
- A. Epinephrine
- B. Acetaminophen
- C. Diphenhydramine
- D. Hydrocortisone
- E. Pantoprazole
Correct Answer: A,C,D
Rationale: Epinephrine treats severe allergic reactions (anaphylaxis), diphenhydramine manages mild to moderate allergic symptoms, and hydrocortisone reduces inflammation in allergic reactions. Acetaminophen is for fever or pain, and pantoprazole is for gastric issues, not allergic reactions.
During the induction stage for treatment of leukemia, the nurse should remove which items that the family has brought into the room?
- A. A Bible.
- B. A picture.
- C. A sachet of lavender.
- D. A hairbrush.
Correct Answer: C
Rationale: During leukemia induction therapy, the client is immunocompromised, and scented items like a lavender sachet may harbor bacteria or cause allergic reactions. A Bible, picture, and hairbrush (if clean) are safe and support emotional well-being.
A client scheduled for a cholecystectomy expresses fear about postoperative pain. Which nursing action is most appropriate?
- A. Administer preoperative analgesics as ordered.
- B. Teach the client about pain management options.
- C. Reassure the client that pain is minimal after surgery.
- D. Refer the client to a pain management specialist.
Correct Answer: B
Rationale: Teaching the client about pain management options, such as PCA or oral analgesics, empowers them to understand and cope with postoperative pain, reducing anxiety. Administering analgesics may not be ordered preoperatively, and reassurance without education is inadequate.
A client with renal calculi has a stent placed. The nurse should teach:
- A. Report blood in urine.
- B. Avoid all activity.
- C. Remove the stent at home.
- D. Expect no discomfort.
Correct Answer: A
Rationale: Blood in urine may indicate stent issues, requiring medical attention.