Nokea
What is the significance of a positive tuberculin skin test?
- A. The client has an active infection.
- B. Antibodies are present in the client's blood.
- C. The client is immune to this type of disease.
- D. The client needs to be in strict isolation.
Correct Answer: B
Rationale: A positive tuberculin skin test indicates the presence of antibodies to tuberculosis, suggesting exposure or latent infection, not necessarily active disease.
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The nurse is caring for a woman who is admitted with pneumonia. On admission, the client is anxious and short of breath but able to respond to questions. One hour later, the client becomes more dyspneic and less responsive, answering only yes and no questions. What is the best action for the nurse to take at this time?
- A. Stimulate the client until the client responds.
- B. Increase the oxygen from the ordered 6 L to 10 L.
- C. Assess the client again in 15 minutes.
- D. Notify the charge nurse of the change in the client's mental status.
Correct Answer: D
Rationale: A change in mental status with worsening dyspnea indicates potential deterioration, requiring immediate notification of the charge nurse.
The charge nurse is making client assignments on a medical floor. Which client should the charge nurse assign to the licensed practical nurse (LPN)?
- A. The client with pneumonia who has a pulse oximeter reading of 91%.
- B. The client with a hemothorax who has Hb of 9 g/dL and Hct of 20%.
- C. The client with chest tubes who has jugular vein distention and BP of 96/60.
- D. The client who is two (2) hours post-bronchoscopy procedure.
Correct Answer: D
Rationale: Post-bronchoscopy (D) is stable for LPN care. Hypoxia (A), anemia (B), and JVD/hypotension (C) require RN assessment.
A farmer who has had a cough for several months has noticed a lack of energy lately. He is being tested for histoplasmosis. Which factor reported by the client would be most related to the diagnosis of histoplasmosis?
- A. He drinks raw milk.
- B. He cleans chicken houses.
- C. He handles fertilizer frequently.
- D. He stepped on a rusty nail recently.
Correct Answer: B
Rationale: Cleaning chicken houses exposes the client to bird droppings, a common source of Histoplasma capsulatum, the fungus causing histoplasmosis.
Which information should the nurse include in the teaching plan for the mother of a child diagnosed with cystic fibrosis (CF)? Select all that apply.
- A. Perform postural drainage and percussion every four (4) hours.
- B. Modify activities to accommodate daily physiotherapy.
- C. Increase fluid intake to one (1) liter daily to thin secretions.
- D. Recognize and report signs and symptoms of respiratory infections.
- E. Avoid anyone suspected of having an upper respiratory infection.
Correct Answer: A,B,D,E
Rationale: Postural drainage (1) helps clear mucus in CF. Modifying activities for physiotherapy (2) ensures adherence. Recognizing infection signs (4) and avoiding respiratory infections (5) prevent exacerbations. One liter of fluid (3) is insufficient for children; fluid needs vary by age and size.
The home health-care nurse is talking on the telephone to a male client diagnosed with hypertension and hears the client sneezing. The client tells the nurse he has been blowing his nose frequently. Which question should the nurse ask the client?
- A. Have you had the flu shot in the last two (2) weeks?
- B. Are there any small children in the home?
- C. Are you taking over-the-counter medicine for these symptoms?
- D. Do you have any cold sores associated with your sneezing?
Correct Answer: C
Rationale: Sneezing and nasal discharge suggest a URI; asking about OTC medications (C) assesses self-treatment and potential interactions. Flu shot timing (A) is irrelevant, children (B) are secondary, and cold sores (D) relate to herpes, not URI.