Nokea
What action assumes greatest priority for Mr. Walker with productive cough, dull percussion notes, and rhonchi?
- A. Determine if Mr. Smith has a history of COPD
- B. Monitor respiratory status for increasing dyspnea
- C. Discuss ways to prevent pneumonia
- D. Obtain a physician’s order for sedatives
Correct Answer: B
Rationale: Monitoring for worsening respiratory distress is critical.
You may also like to solve these questions
Mary, who is diagnosed with osteomyelitis, may not heal properly unless she has
- A. Debridement and drainage of the area.
- B. Immobilization of the area.
- C. Ice packs alternating with moist heat, applied externally.
- D. Internal fixation device inserted.
Correct Answer: A
Rationale: Debridement and drainage are necessary to remove infected tissue and promote healing.
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.
What stressors is she experiencing (select all that apply)?
- A. Change in role within the family
- B. Lack of respite from caregiving responsibilities
- C. Conflict in the family related to decisions about caregiving
- D. Financial depletion of resources as a result of her inability to work
Correct Answer: C
Rationale: The correct answers are all listed. Each option represents a potential stressor experienced by the caregiver due to her father's condition and the dynamics within her family.
When prioritizing client care after receiving change-of-shift report, which of the following clients should the nurse plan to see first?
- A. A client who is scheduled for an abdominal x-ray and is awaiting transport
- B. A client who has a prescription for discharge
- C. A client who received oral pain medication 30 minutes ago
- D. A client who told an assistive personnel he is short of breath
Correct Answer: D
Rationale: The correct answer is D because a client who is experiencing shortness of breath may be in a critical condition requiring immediate intervention to prevent respiratory distress or failure. This is a high-priority issue that needs prompt assessment and intervention to ensure the client's safety.
A: A client awaiting transport for an abdominal x-ray is not in an immediate life-threatening situation.
B: A client with a prescription for discharge can typically wait as the discharge process can be coordinated by other healthcare team members.
C: A client who received oral pain medication 30 minutes ago is not experiencing an urgent or life-threatening situation, as the medication may take time to alleviate pain.
Priority treatment of a fracture is
- A. Surgical reduction of the fracture.
- B. Immobilization of the area.
- C. Insertion of an internal fixation device.
- D. Reduction of the fracture.
Correct Answer: B
Rationale: Immobilization prevents further injury and promotes healing.