Nokea
What sign would you expect to find when assessing Mr. Stout with chronic bronchitis?
- A. Loss of weight
- B. Chronic cough
- C. Barrel chest
- D. Scanty sputum
Correct Answer: B
Rationale: Chronic cough is a hallmark symptom of chronic bronchitis.
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A 29-year-old client is admitted for a hysterectomy and is expressing concern regarding the procedure. Shortly into the preoperative teaching, the client complains of a tightness in the chest, feelings of suffocation, light-headedness, and tingling in the hands. The client's respirations are rapid and deep. The nursing assessment reveals that this client is:
- A. having a heart attack.
- B. wanting attention from the nurses.
- C. suffering from complete upper airway obstruction.
- D. hyperventilating.
Correct Answer: D
Rationale: Classic symptoms of a heart attack include a heaviness or squeezing pain in the chest, pain spreading to the jaw, neck, and arm. Nausea and vomiting, sweating, and shortness of breath may also be present. However, the client does not exhibit these symptoms. Clients suffering from anxiety or fear prior to surgical procedures may develop hyperventilation. This client is not seeking attention. Symptoms of complete airway obstruction include not being able to speak, lack of airflow between the nose and mouth, and absent breath sounds. A tightness in the chest, feelings of suffocation, light-headedness, tingling in the hands, and rapid deep respirations are signs and symptoms of hyperventilation, which is almost always a manifestation of anxiety.
Tom complains of hunger and lack of energy midmorning. What suggestion would be most helpful?
- A. As a midmorning snack drink a glass of apple juice and eat a pear
- B. Drink only coffee with sugar for breakfast
- C. Eat a sweet roll midmorning
- D. Drink a glass of orange juice and eat three pieces of toast for breakfast
Correct Answer: A
Rationale: A balanced snack like apple juice and a pear provides quick energy and nutrients without excessive calories.
7. According to Traditional Chinese Medicine, when does disease occur?
- A. Yin and yang become imbalanced, altering the flow of Qi.
- B. Acupoints in Qi channels become obstructed, preventing the release of Qi.
- C. The body’s natural healing abilities are impaired by obstruction of fluid channels.
- D. The individual is out of harmony with nature and requires spiritualism and mysticism to reestablish balance.
Correct Answer: A
Rationale: In Traditional Chinese Medicine, disease occurs when Yin and Yang become imbalanced, disrupting the flow of Qi, as described in option A.
The trauma unit nurse has received a report on a client who has multiple injuries following a motor vehicle crash. Which of the following actions should the nurse plan to take first?
- A. Evaluate chest expansion.
- B. Check pupillary response to light.
- C. Assess the capillary refill.
- D. Check the client's response to questions about place and time.
Correct Answer: A
Rationale: The correct answer is A: Evaluate chest expansion. This is the priority action because it assesses the client's airway and breathing, which are critical for survival. Checking chest expansion helps to identify any potential respiratory compromise or underlying lung injuries. Assessing pupillary response (B) and capillary refill (C) are important, but they are secondary to ensuring adequate oxygenation. Checking the client's orientation to place and time (D) is important for neurological assessment but is not as critical as assessing airway and breathing in this scenario.
A client's arterial blood gas results show a pH of 7.3 and a PaCO2 of 50 mm Hg. The client is experiencing which of the following acid-base imbalances?
- A. Metabolic acidosis
- B. Metabolic alkalosis
- C. Respiratory acidosis
- D. Respiratory alkalosis
Correct Answer: C
Rationale: The correct answer is C: Respiratory acidosis. In this case, the low pH indicates acidosis, and the elevated PaCO2 indicates respiratory involvement. In respiratory acidosis, the lungs cannot eliminate enough CO2, leading to an increase in carbonic acid and a decrease in pH. Metabolic acidosis (choice A) would involve a primary decrease in bicarbonate levels, not seen in this scenario. Metabolic alkalosis (choice B) would involve an increase in bicarbonate levels, which is not indicated by the given information. Respiratory alkalosis (choice D) would have a low PaCO2 and an elevated pH, opposite of what is seen here.