Nokea
What is a typical parasomnia?
- A. Cataplexy
- B. Hypopnea
- C. Sleep apnea
- D. Sleep terrors
Correct Answer: D
Rationale: The correct answer is D. Sleep terrors are a classic example of parasomnias, which are abnormal behaviors during sleep. Cataplexy (A) is associated with narcolepsy, hypopnea (B) refers to shallow breathing, and sleep apnea (C) involves breathing interruptions.
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The primary nursing diagnosis for a client with congestive heart failure with pulmonary edema is:
- A. Pain.
- B. Impaired gas exchange.
- C. Decrease Cardiac output.
- D. Fluid volume excess.
Correct Answer: B
Rationale: Impaired gas exchange is the main issue in pulmonary edema.
What correctly describes pursed-lip breathing?
- A. Breathe in to count of 4 and out to count of 2, pursing lips
- B. Breathe in through nose and slowly exhale through pursed lips
- C. Place one hand on abdomen and other on chest, inhaling through pursed lips and exerting pressure on inspiration
- D. Take in a deep breath, through pursed lips, then let out one-third; continue this pattern
Correct Answer: B
Rationale: Pursed-lip breathing involves slow exhalation to prolong expiration and improve airflow.
Josie is the mother of a healthy 19-year-old having surgery tomorrow. After the surgeon discusses the surgery, risks, and benefits with the patient and her mother, the mother wants to sign the consent form. The most appropriate response to this would be
- A. Of course she can sign the consent form; after all, the patient is her daughter.
- B. While you appreciate the concern for her daughter, the patient is a consenting adult and legally has to sign her own consent form.
- C. No consent form must be signed.
- D. Why do not both the patient and her mother sign the form?
Correct Answer: B
Rationale: Adult patients have the legal right to consent to their own medical procedures.
A newly graduated nurse in the hospital states that, since she is so new, she cannot participate in quality improvement (QI) projects. What response by the precepting nurse is best?
- A. All staff nurses are required to participate in quality improvement projects.
- B. Even as a new nurse, you can implement activities designed to improve care.
- C. It's easy to identify which indicators should be used to measure quality improvement.
- D. You should ask to be assigned to the research and quality committee.
Correct Answer: B
Rationale: The correct answer is B because even as a new nurse, one can contribute to improving care by implementing activities. This response encourages the new nurse to actively engage in the quality improvement process, fostering a sense of ownership and commitment to enhancing patient outcomes. Choice A is incorrect as participation in QI projects is not solely based on tenure. Choice C is incorrect as identifying indicators requires knowledge and experience. Choice D is incorrect as it suggests a specific assignment rather than empowering the new nurse to take initiative in improving care.
A client with chronic obstructive pulmonary disease (COPD) who has been receiving oxygen therapy at 2 L/min now has a respiratory rate of 10 breaths/min. What action should the nurse take first?
- A. Increase the oxygen flow rate to 4 L/min.
- B. Administer a bronchodilator via nebulizer.
- C. Encourage the client to take deep breaths.
- D. Assess the client's mental status and level of consciousness.
Correct Answer: D
Rationale: The correct answer is D, assessing the client's mental status and level of consciousness. This is the first action to take because a respiratory rate of 10 breaths/min in a COPD client receiving oxygen therapy may indicate respiratory depression or impending respiratory failure. Assessing mental status and level of consciousness can help determine if the client is experiencing hypoxia. Increasing oxygen flow rate (A) without assessing the client first can be dangerous if the client is retaining carbon dioxide. Administering a bronchodilator (B) may not address the underlying issue of respiratory depression. Encouraging deep breaths (C) may not be appropriate if the client is in respiratory distress.