Nokea
The nurse provides directions to the client on the proper use of a peak flow meter. Arrange the steps for the nurse's instruction to the client on the proper use of a peak flow meter in the correct sequence.
- A. Slide the marker to zero.
- B. Take a deep breath.
- C. Put the mouthpiece of the flow meter into your mouth.
- D. Blow out as fast as you can.
- E. Empty all of the air from your lungs.
- F. Record the highest rating after the current sequence.
Correct Answer: A, B, C, D, E, F
Rationale: The correct sequence is: 1. Slide the marker to zero, 2. Take a deep breath, 3. Put the mouthpiece in your mouth, 4. Blow out as fast as you can, 5. Empty all of the air from your lungs, 6. Record the highest rating.
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The nurse is caring for a client on a ventilator and the alarm goes off. Which action should the nurse implement first?
- A. Notify the respiratory therapist immediately.
- B. Check the ventilator to determine the cause.
- C. Elevate the head of the client's bed.
- D. Assess the client's oxygen saturation.
Correct Answer: B
Rationale: Checking the ventilator (B) is the first action to identify the alarm’s cause (e.g., disconnection, obstruction), per the ABCs. Notifying the therapist (A) delays intervention. Elevating the bed (C) is irrelevant. Assessing oxygen saturation (D) is secondary to addressing the ventilator issue.
The nurse observes the unlicensed assistive personnel (UAP) removing the nasal cannula from the client diagnosed with COPD while ambulating the client to the bathroom. Which action should the nurse implement?
- A. Praise the UAP because this prevents the client from tripping on the oxygen tubing.
- B. Place the oxygen back on the client while sitting in the bathroom and say nothing.
- C. Explain to the UAP in front of the client oxygen must be left in place at all times.
- D. Discuss the UAP's action with the charge nurse so appropriate action can be taken.
Correct Answer: B
Rationale: COPD clients need continuous oxygen; replacing it (B) corrects the error safely. Praising (A) is incorrect, explaining in front of client (C) is unprofessional, and escalating (D) is premature.
The nurse is caring for the client diagnosed with end-stage COPD. Which data warrant immediate intervention by the nurse?
- A. The client's pulse oximeter reading is 92%.
- B. The client's arterial blood gas level is 74.
- C. The client has SOB when walking to the bathroom.
- D. Rusty colored sputum.
Correct Answer: D
Rationale: Rusty sputum (D) suggests hemoptysis or infection, a critical finding in end-stage COPD. SpO2 92% (A), PaO2 74 (B), and SOB (C) are expected but less urgent.
A patient with active tuberculosis is taking Ethambutol. As the nurse you make it priority to assess the patient's?
- A. hearing
- B. mental status
- C. vitamin B6 level
- D. vision
Correct Answer: D
Rationale: Ethambutol can cause optic neuritis, leading to vision changes. The nurse must prioritize assessing the patient's vision to detect this side effect early.
The 56-year-old client diagnosed with tuberculosis (Tb) is being discharged. Which statement made by the client indicates an understanding of the discharge instructions?
- A. I will take my medication for the full three (3) weeks prescribed.
- B. I must stay on the medication for months if I am to get well.
- C. I can be around my friends because I have started taking antibiotics.
- D. I should get a Tb skin test every three (3) months to determine if I am well.
Correct Answer: B
Rationale: TB treatment requires months of antibiotics (B) for cure. Three weeks (A) is too short, antibiotics don’t eliminate transmission risk immediately (C), and skin tests (D) monitor exposure, not cure.