Nokea
Tom is diagnosed with an aortic aneurysm. He asks why this did not show up on his annual physical examination. You respond by saying
- A. It did show and your physician did not want to alarm you.
- B. You probably do not remember that your physician told you about your condition.
- C. Aortic aneurysms are asymptomatic.
- D. Aortic aneurysms are always symptomatic.
Correct Answer: C
Rationale: Aortic aneurysms often do not present symptoms until they become large or rupture.
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A client with respiratory failure is receiving mechanical ventilation and continues to produce ABG results indicating respiratory acidosis. Which action should you expect to correct this problem?
- A. Increase the ventilator rate from 6 to 10 per minute
- B. Decrease the ventilator rate from 10 to 6 per minute
- C. Increase the oxygen concentration from 30% to 40%
- D. Decrease the oxygen concentration from 40% to 30%
Correct Answer: A
Rationale: Increasing the ventilator rate enhances CO2 removal, correcting respiratory acidosis by improving ventilation.
What nursing measure would be most helpful in soliciting Mr. Ross’s cooperation with arm and shoulder exercises?
- A. Inform Mr. Ross that these exercises must be done before each meal and at bedtime
- B. Give Mr. Ross a booklet which diagrams the exercises
- C. Teach Mrs. Ross how to do these exercises
- D. Ask Mr. Ross which times are most convenient for him to exercise
Correct Answer: D
Rationale: Tailoring exercise schedules to patient preferences enhances adherence.
When performing a neurologic assessment on Ken, the physician notices that there is contraction of his facial muscle after tapping the facial nerve anterior to his ear. He recognizes this as Chvostek’s sign. This is seen in:
- A. Hyponatremia.
- B. Hypokalemia.
- C. Hypocalcemia.
- D. Hypomagnesemia.
Correct Answer: C
Rationale: The correct answer is Hypocalcemia (C). Chvostek's sign is a clinical sign of hypocalcemia, where tapping the facial nerve causes twitching of facial muscles due to increased neuromuscular excitability caused by low calcium levels.
A client just had a flexible bronchoscopy. Which of the following nursing actions is appropriate?
- A. Withhold food and liquids until the client's gag reflex returns.
- B. Irrigate the client's throat every 4 hours.
- C. Have the client refrain from talking for 24 hours.
- D. Suction the client's oropharynx frequently.
Correct Answer: A
Rationale: The correct answer is A: Withhold food and liquids until the client's gag reflex returns. After a flexible bronchoscopy, the client may have a decreased gag reflex due to topical anesthesia used during the procedure, which increases the risk of aspiration. Withholding food and liquids helps prevent aspiration until the gag reflex returns, usually within 1-2 hours.
B: Irrigating the client's throat every 4 hours is unnecessary and may not be indicated post-bronchoscopy.
C: Having the client refrain from talking for 24 hours is not necessary after a flexible bronchoscopy unless specifically instructed by the healthcare provider.
D: Suctioning the client's oropharynx frequently is not indicated unless there is a clinical indication for it, such as excessive secretions or respiratory distress. Frequent suctioning can increase the risk of trauma to the airway.
What does tenderness behind the ear indicate in a client with otitis media?
- A. Mastoiditis
- B. Tinnitus
- C. Labyrinthitis
- D. Septicemia
Correct Answer: A
Rationale: Tenderness behind the ear may indicate mastoiditis, an infection of the mastoid bone.