Nokea
What condition can develop if Mr. Taylor’s chest tube is accidentally pulled out?
- A. Tension pneumothorax
- B. Open pneumothorax
- C. Hemopneumothorax
- D. Paradoxic respirations
Correct Answer: B
Rationale: An open pneumothorax occurs when air enters the pleural space through an external opening.
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Priority Decision: The nurse prepares to interview a patient for a nursing history but finds the patient in obvious pain. Which action by the nurse is the best at this time?
- A. Delay the interview until the patient is free of pain.
- B. Administer pain medication before initiating the interview.
- C. Gather as much information as quickly as possible by using closed questions that require brief answers.
- D. Ask only those questions pertinent to the specific problem and complete the interview when the patient is more comfortable.
Correct Answer: A
Rationale: The correct answer is 'Delay the interview until the patient is free of pain.' Pain can interfere with concentration and communication, making it difficult for the patient to provide accurate information. Delaying the interview ensures better quality data collection once the patient is comfortable.
Which type of agent does sulfur mustard fall under?
- A. Nerve agents
- B. Blistering agents
- C. Respiratory toxins
- D. Cyanide poisonings
Correct Answer: B
Rationale: The correct answer is B because sulfur mustard is a blistering agent that causes skin and respiratory damage.
While teaching a client about their medications, the client asks how long it will take before the effects of lithium take place. What is the best response of the nurse?
- A. Immediately.
- B. Several days.
- C. 2 weeks.
- D. 1 month.
Correct Answer: C
Rationale: Lithium typically takes 2 weeks to show therapeutic effects.
A client continually repeats phrases that others have just said. The nurse recognizes this behavior as:
- A. Autistic.
- B. Ecopraxic.
- C. Echolalic.
- D. Catatonic.
Correct Answer: C
Rationale: Echolalia is the repetition of words or phrases heard from others.
The patient will be placed under moderate sedation to allow realignment of a fracture in the emergency department. When the family asks about this anesthesia, what should the nurse tell them?
- A. Includes inhalation agents
- B. Induces high levels of sedation
- C. Frequently used for traumatic injuries
- D. Patients remain responsive and breathe without assistance
Correct Answer: D
Rationale: Moderate sedation keeps patients responsive and maintains spontaneous breathing.