Nokea
What is the rationale for administering oxygen in treating COPD?
- A. Relieve hypoxemia
- B. Increase carbon dioxide retention
- C. Increase intensity of respiratory drive
- D. Decrease respiratory secretions
Correct Answer: A
Rationale: Oxygen therapy alleviates hypoxemia, improving tissue perfusion.
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List the order in which you will assess these patients.
- A. An ambulatory, dazed 25-year-old male with a bandaged head wound
- B. An irritable infant with a fever, petechiae, and nuchal rigidity
- C. A 35-year-old jogger with a twisted ankle, having pedal pulse and no deformity
- D. A 50-year-old female with moderate abdominal pain and occasional vomiting
Correct Answer: B
Rationale: The infant with fever, petechiae, and nuchal rigidity may indicate meningitis, a life-threatening condition requiring immediate attention.
9. When the family members of a postoperative patient leave after a visit, the patient tells the nurse that his family gave him a headache by fussing over him so much. What is an appropriate intervention by the nurse?
- A. Administer the PRN analgesic prescribed for his postoperative pain.
- B. Ask the patient’s permission to use acupressure to ease his headache.
- C. Reassure the patient that his headache will subside now that his family has gone.
- D. Teach the patient biofeedback methods to relieve his headaches by controlling cerebral blood flow.
Correct Answer: B
Rationale: Asking the patient’s permission to use acupressure (option B) is an appropriate non-pharmacological intervention that respects patient autonomy and may effectively alleviate the headache.
A client complaining of severe shortness of breath is diagnosed with congestive heart failure. The nurse observes a falling pulse oximetry. The client's color changes to gray and she expectorates large amounts of pink frothy sputum. The first action of the nurse would be which of the following?
- A. Call the health care provider.
- B. Check vital signs.
- C. Position in high Fowler's.
- D. Administer oxygen.
Correct Answer: D
Rationale: Oxygen administration is immediate to address hypoxemia.
On assessing Mr. Puff, what would you expect to find?
- A. ‘Blue bloater’ appearance
- B. Copious amount of thin sputum
- C. Increased anteroposterior chest diameter
- D. Prolonged inspiratory time
Correct Answer: C
Rationale: The correct answer is C: Increased anteroposterior chest diameter. In patients with chronic obstructive pulmonary disease (COPD), like Mr. Puff, there is often air trapping leading to hyperinflation of the lungs. This results in an increased anteroposterior chest diameter, known as a "barrel chest" appearance. Option A (‘Blue bloater’ appearance) is associated with chronic bronchitis, not necessarily COPD. Option B (Copious amount of thin sputum) is more indicative of bronchiectasis. Option D (Prolonged inspiratory time) is a nonspecific finding and not typically associated with COPD.
A client in a clinic presents with an acute asthma exacerbation. Which of the following medications should reduce the symptoms?
- A. Cromolyn via a metered-dose inhaler
- B. Montelukast orally
- C. Budesonide via a dry-powder inhaler
- D. Albuterol via a jet nebulizer
Correct Answer: D
Rationale: The correct answer is D: Albuterol via a jet nebulizer. Albuterol is a short-acting beta agonist that works by relaxing the muscles in the airways, helping to open them up and improve airflow. When administered via a nebulizer, it provides quick relief during an acute asthma exacerbation by directly targeting the airways. Cromolyn (A) is a mast cell stabilizer that is used for preventing asthma symptoms, not for acute exacerbations. Montelukast (B) is a leukotriene receptor antagonist that is used for maintenance therapy, not for immediate relief. Budesonide (C) is an inhaled corticosteroid used for long-term control of asthma, not for acute symptom relief.