Nokea
What are clinical manifestations of insomnia (select all that apply)?
- A. Narcolepsy
- B. Fragmented sleep
- C. Long sleep latency
- D. Morning headache
Correct Answer: B
Rationale: The correct answers are B, C, and F. Fragmented sleep, long sleep latency, and difficulty concentrating are common symptoms of insomnia. Narcolepsy (A) is unrelated, morning headache (D) can occur but is less common, and daytime sleepiness (E) is more typical of sleep apnea.
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Which action should the nurse take to reduce the risk of ventilator-associated pneumonia in a client with an endotracheal tube receiving mechanical ventilation?
- A. Position the head of the client's bed flat
- B. Turn the client every 4 hours
- C. Brush the client's teeth with a suction toothbrush every 12 hours
- D. Provide humidity by maintaining moisture within the ventilator tubing
Correct Answer: C
Rationale: The correct answer is C: Brush the client's teeth with a suction toothbrush every 12 hours. This is crucial in reducing the risk of ventilator-associated pneumonia as it helps prevent the buildup of bacteria in the oral cavity, which can be aspirated into the lungs. Brushing the teeth regularly maintains oral hygiene, decreasing the chances of infection.
A: Positioning the head of the client's bed flat can increase the risk of aspiration and pneumonia.
B: Turning the client every 4 hours is important for preventing pressure ulcers but does not directly reduce the risk of ventilator-associated pneumonia.
D: Providing humidity within the ventilator tubing is important for preventing mucous plugs but does not directly address oral hygiene, which is key in preventing pneumonia.
A healthcare provider is preparing to admit a client to the PACU who received a competitive neuromuscular blocking agent. Which of the following items should the provider place at the client's bedside?
- A. Bag valve mask device
- B. Defibrillator machine
- C. Chest tube equipment
- D. Central venous catheter tray
Correct Answer: A
Rationale: The correct answer is A: Bag valve mask device. In the PACU, a client who received a competitive neuromuscular blocking agent may have impaired respiratory function. Placing a bag valve mask device at the bedside is crucial for providing immediate respiratory support if needed. This device allows manual ventilation in case of respiratory distress.
Summary:
- Choice B: Defibrillator machine is not necessary for a client receiving a competitive neuromuscular blocking agent.
- Choice C: Chest tube equipment is not typically needed for this situation.
- Choice D: Central venous catheter tray is not directly related to the respiratory support required for a client with impaired respiratory function.
When performing tracheostomy care, which intervention should the nurse implement?
- A. Use aseptic technique.
- B. Clean the inner cannula with mild soap and water.
- C. Secure new tracheostomy ties before removing old ones.
- D. Apply suction when inserting the catheter.
Correct Answer: C
Rationale: The correct answer is C: Secure new tracheostomy ties before removing old ones. This is essential to ensure the patient's airway remains stable and secure during the procedure. By securing the new ties first, the tracheostomy tube will not accidentally dislodge or become displaced.
A: Using aseptic technique is important but not the immediate priority in this situation.
B: Cleaning the inner cannula is a routine part of tracheostomy care but not the primary intervention during tie change.
D: Applying suction when inserting the catheter is incorrect as suctioning should be performed after securing the new ties to maintain airway patency.
A client with tuberculosis is starting medication therapy with isoniazid, rifampin, and pyrazinamide. Which of the following instructions should the nurse include?
- A. Take isoniazid with an antacid.
- B. Provide a sputum specimen every 2 weeks to the clinic for testing.
- C. Expect your sputum cultures to be negative after 6 months of therapy.
- D. Drink at least 8 ounces of water when you take the pyrazinamide tablet.
Correct Answer: D
Rationale: Rationale:
Taking pyrazinamide on an empty stomach can cause stomach upset. Drinking water helps prevent this.
A: Isoniazid should be taken on an empty stomach, not with an antacid.
B: Sputum specimens are usually collected at the beginning of treatment, not every 2 weeks.
C: Negative sputum cultures might not be achieved until later in treatment, not after 6 months.
In planning Mrs. Filbert's care during an acute attack of Meniere disease, it would be most important to
- A. encourage her to discuss her feelings about her illness
- B. keep her siderails up and provide assistance when she is permitted out of bed
- C. instruct her about prescribed dietary modifications
- D. encourage her to walk around her room so that her joints will not get stiff
Correct Answer: C
Rationale: Dietary changes, such as reducing salt intake, play a key role in managing Meniere disease by helping control fluid balance in the inner ear.