What are the factors that interfere with a client’s learning capacity? How can receptiveness to learning be increased?
- A. Stress,fatigue and lack of interest; create a supportive environment.
- B. Lack of resources; provide more materials.
- C. Cultural differences; adapt teaching methods.
- D. None of the above.
Correct Answer: A
Rationale: Factors like stress and fatigue hinder learning. Creating a supportive, stress-free environment enhances receptiveness.
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Why should the nurse closely monitor older adults when they are receiving IV therapy?
- A. Because their defense mechanisms are less efficient.
- B. Because they are prone to fluid overload.
- C. Because they are prone to increased renal efficiency.
- D. Because they have inadequate intake of dietary fiber.
Correct Answer: B
Rationale: The correct answer is B because older adults are more susceptible to fluid overload due to decreased kidney function and other physiological changes.
Describe the relationship between receptors and neurotransmitters.
- A. Increased alertness
- B. Lower immune response
- C. Faster metabolism
- D. Enhanced digestion
Correct Answer: B
Rationale: The correct answer is B because it is the most appropriate response based on physiological and medical principles.
A client has a three-chamber closed chest tube system, and the water seal chamber rises with client inspiration. What action should the nurse take?
- A. Continue to monitor the client.
- B. Immediately notify the healthcare provider.
- C. Reposition the client to the left side.
- D. Clamp the chest tube near the water seal.
Correct Answer: A
Rationale: The correct answer is A: Continue to monitor the client. When the water seal chamber rises with client inspiration, it indicates normal functioning of the chest tube system, allowing air to exit the pleural space. Monitoring ensures proper chest tube function. Option B is incorrect because there is no indication of immediate need for healthcare provider notification. Option C is unnecessary as repositioning won't address the issue. Option D is incorrect and dangerous as clamping the chest tube can lead to tension pneumothorax.
A client in the late stage of inhalation anthrax requires a plan of care. What is appropriate to include in the plan of care?
- A. Provide respiratory support.
- B. Place the client in droplet isolation.
- C. Administer antihypertensive medications.
- D. Monitor ascites.
Correct Answer: A
Rationale: Step 1: Inhalation anthrax causes severe respiratory distress.
Step 2: Providing respiratory support helps maintain oxygenation.
Step 3: Oxygen therapy or mechanical ventilation may be needed.
Step 4: This choice directly addresses the critical needs of the client.
Summary:
- B: Droplet isolation is not needed as anthrax is not transmitted person-to-person.
- C: Antihypertensive medications are irrelevant to inhalation anthrax treatment.
- D: Ascites monitoring is not a priority in late-stage inhalation anthrax.
A client is being admitted to the surgical unit from the PACU following a cholecystectomy. Which of the following assessments is the nurse's priority?
- A. Bowel sounds
- B. Surgical dressing
- C. Temperature
- D. Oxygen saturation
Correct Answer: D
Rationale: The correct answer is D: Oxygen saturation. The priority assessment after a cholecystectomy is monitoring the client's oxygen saturation to ensure adequate oxygenation post-surgery. Decreased oxygen saturation can indicate respiratory distress, which requires immediate intervention. Bowel sounds (A) are important but not the priority post-cholecystectomy. Surgical dressing (B) should be assessed, but it is not as critical as monitoring oxygen saturation. Temperature (C) is also important, but ensuring oxygenation takes precedence in the immediate postoperative period.