Nokea
The occupational nurse for a mining company is planning a class on the risks of working with toxic substances to comply with the 'Right to Know' law. Which information should the nurse include in the presentation? Select all that apply.
- A. A client who smokes cigarettes has a drastically increased risk for lung cancer.
- B. Floors need to be clean and dust needs to be wet to prevent transfer of dust.
- C. The air needs to be monitored at specific times to evaluate for exposure.
- D. Surface areas need to be painted every year to prevent the accumulation of dust.
- E. Employees should wear the appropriate personal protective equipment.
Correct Answer: A,B,C
Rationale: Smoking increases lung cancer risk (1), relevant to toxic exposures. Wet dust control (2) reduces airborne particles. Air monitoring (3) ensures safe exposure levels. PPE (5) is critical for protection. Annual painting (4) is not a standard dust control measure.
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The client diagnosed with chronic sinusitis who has undergone a Caldwell-Luc procedure is complaining of pain. Which intervention should the nurse implement first?
- A. Administer the narcotic analgesic intravenous push (IVP).
- B. Perform gentle oral hygiene.
- C. Place the client in semi-Fowler's position.
- D. Assess the client's pain.
Correct Answer: D
Rationale: Pain assessment (D) is the first step to determine severity and guide treatment. Narcotics (A), oral hygiene (B), and positioning (C) follow based on assessment.
A patient is receiving continuous IV Heparin for anticoagulation therapy for the treatment of a DVT. In order for this medication to have a therapeutic effect on the patient, the aPTT should be?
- A. 0.5-2.5 times the normal value range
- B. 2-3 times the normal value range
- C. 1.5-2.5 times the normal value range
- D. 1-3.5 times the normal value range
Correct Answer: C
Rationale: An aPTT should be 1.5-2.5 times the normal value range for Heparin to achieve a therapeutic effect in a patient to prevent blood clots. If the aPTT is too low, blood clots can form. If the aPTT is too high, bleeding can occur.
A patient receiving medical treatment for an active tuberculosis infection asks when she can starting going out in public again. You respond that she is no longer contagious when:
- A. She has 3 negative sputum cultures
- B. Her signs and symptoms improve
- C. She has completed the full medication regime
- D. Her chest x-ray is normal
- E. She has been on tuberculosis medications for about 3 weeks
Correct Answer: A,B,E
Rationale: These are all criteria for when a patient with active TB can return to public life (school, work, running errands). Until then they are still contagious and must stay home in isolation.
When the nurse obtains the nasal swab, which action is most accurate?
- A. The nurse dons sterile gloves before obtaining the specimen.
- B. The swab is placed in the anterior portion of the nare and swept superiorly.
- C. The client is asked to blow the nose before the specimen is collected.
- D. The nurse uses separate applicators for each nare.
Correct Answer: D
Rationale: Using separate applicators for each nare prevents cross-contamination and ensures an accurate sample for MRSA screening.
Which datum requires immediate intervention by the nurse for the client diagnosed with asbestosis?
- A. The client develops an S3 heart sound.
- B. The client has clubbing of the fingers.
- C. The client is fatigued in the afternoon.
- D. The client has basilar crackles in all lobes.
Correct Answer: A
Rationale: An S3 heart sound (A) indicates heart failure, a serious complication in asbestosis due to pulmonary hypertension, requiring immediate intervention. Clubbing (B) is a chronic finding, not acute. Fatigue (C) is common but not urgent. Basilar crackles (D) are expected in asbestosis and less critical than cardiac issues.