Nokea
What is the priority nursing intervention for a patient experiencing an acute asthma attack?
- A. Administer bronchodilators
- B. Monitor oxygen saturation
- C. Provide supplemental oxygen
- D. Start IV fluids
Correct Answer: A
Rationale: The correct answer is to administer bronchodilators. In an acute asthma attack, the priority is to open the airways and improve airflow. Bronchodilators like albuterol are crucial in providing immediate relief to the patient. Monitoring oxygen saturation (choice B) is important but administering bronchodilators takes precedence in managing the acute attack. Providing supplemental oxygen (choice C) may be necessary but addressing the airway obstruction with bronchodilators is the priority. Starting IV fluids (choice D) is not the priority in an acute asthma attack unless specifically indicated for other reasons such as dehydration.
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Which electrolyte imbalance should be closely monitored in patients on furosemide?
- A. Hypokalemia
- B. Hyponatremia
- C. Hyperkalemia
- D. Hypercalcemia
Correct Answer: A
Rationale: The correct answer is A: Hypokalemia. Furosemide is a loop diuretic that can lead to potassium loss in the body, resulting in hypokalemia. Monitoring potassium levels is crucial in patients on furosemide to prevent complications such as cardiac arrhythmias and muscle weakness. Choice B, hyponatremia, is not typically associated with furosemide use. Hyperkalemia (choice C) and hypercalcemia (choice D) are not commonly linked to furosemide therapy; therefore, they are incorrect choices.
What is the best intervention for a patient with constipation?
- A. Administer a stool softener
- B. Encourage fluid intake
- C. Provide a high-fiber diet
- D. Administer a laxative
Correct Answer: B
Rationale: Encouraging fluid intake is the best intervention for a patient with constipation. Fluids help soften stools, making them easier to pass. While stool softeners and laxatives can also help with constipation, they are more of a short-term solution and may not address the root cause. A high-fiber diet is beneficial for preventing constipation in the long run, but in the immediate situation of constipation, fluid intake is key.
A client with heart failure is being taught about dietary modifications by a nurse. Which of the following client statements indicates an understanding of the teaching?
- A. I will increase my intake of canned vegetables.
- B. I will limit my daily sodium intake to 2 grams.
- C. I will increase my intake of whole grains.
- D. I will reduce my intake of processed meats.
Correct Answer: D
Rationale: The correct answer is 'D: I will reduce my intake of processed meats.' This choice indicates an understanding of the teaching because processed meats are high in sodium, which can worsen heart failure due to fluid retention. Choices A, B, and C do not directly address the issue of reducing sodium intake, which is crucial for clients with heart failure. Increasing canned vegetable intake (A) may not always be advisable due to potential high sodium content in canned products. Limiting sodium intake to 2 grams daily (B) is a good practice, but it's more specific to sodium restriction rather than addressing the source of sodium like processed meats. Increasing whole grains (C) is generally beneficial but does not directly relate to reducing sodium intake in heart failure clients.
A nurse is planning care for a client who has a new diagnosis of deep vein thrombosis (DVT). Which of the following interventions should the nurse include?
- A. Massage the affected extremity every 4 hours.
- B. Encourage the client to remain on bed rest.
- C. Apply cold packs to the affected extremity.
- D. Encourage the client to ambulate frequently.
Correct Answer: C
Rationale: The correct intervention for a client with deep vein thrombosis (DVT) is to apply cold packs to the affected extremity. Cold packs help reduce swelling and pain by causing vasoconstriction. Massaging the affected extremity could dislodge a clot, leading to serious complications. Encouraging bed rest may increase the risk of clot propagation, while frequent ambulation is contraindicated as it can dislodge clots.
How should a healthcare provider manage a patient with chronic pain?
- A. Administer analgesics
- B. Encourage physical activity
- C. Administer non-pharmacological interventions
- D. Encourage deep breathing exercises
Correct Answer: A
Rationale: Administering prescribed analgesics is a crucial aspect of managing chronic pain effectively. Analgesics help alleviate pain symptoms and improve the patient's quality of life. While physical activity and non-pharmacological interventions can also play a role in pain management, the immediate need for relief in chronic pain often requires pharmacological intervention. Encouraging deep breathing exercises may provide some relief in certain situations, but it may not be as effective as analgesics for managing chronic pain.