Nokea
What strategies could decrease the distress of rotating shifts for nurses (select all that apply)?
- A. Take a brief onsite nap
- B. Use sleep hygiene practices
- C. Sleep just before going to work
- D. Maintain consistent sleep/wake schedules even on days off (if possible)
Correct Answer: A
Rationale: The correct answers are A, B, and D. Brief naps (A), sleep hygiene (B), and consistent schedules (D) improve adaptation to shift work. Sleeping just before work (C) can worsen sleep quality.
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Which of the following is a finding that is most often associated with endometrial cancer?
- A. Thickened endometrial lining on ultrasound
- B. Irregular periods
- C. Young age
- D. Dyspareunia
Correct Answer: A
Rationale: A thickened endometrial lining on ultrasound is commonly associated with endometrial cancer, indicating abnormal cell growth.
A client is 1 day postoperative following a lobectomy with a chest tube drainage system in place. Which finding by the nurse indicates a need for intervention?
- A. Chest tube eyelets not visible
- B. Continuous bubbling in the suction control chamber
- C. Presence of tidal fluctuation in the water seal chamber
- D. Development of subcutaneous emphysema
Correct Answer: D
Rationale: The correct answer is D: Development of subcutaneous emphysema. This finding indicates air leakage, which can lead to potential complications like tension pneumothorax. Subcutaneous emphysema is a serious concern that requires immediate intervention.
A: Chest tube eyelets not visible - This is not a concerning finding as long as the chest tube is properly secured and functioning.
B: Continuous bubbling in the suction control chamber - This can indicate proper functioning of the system.
C: Presence of tidal fluctuation in the water seal chamber - This indicates that the system is working correctly, with the water seal chamber fluctuating with the patient's breathing.
A client is 12 hours postoperative following colon resection. Which of the following interventions should the nurse include in the plan to reduce respiratory complications?
- A. Use incentive spirometer every 4 hours while awake.
- B. Initiate ambulation after discontinuing the NG tube.
- C. Maintain a supine position with an abdominal binder.
- D. Splint the incision to support coughing every 2 hours.
Correct Answer: D
Rationale: The correct answer is D because splinting the incision supports coughing, which helps clear secretions and prevents respiratory complications. It is essential postoperatively to prevent atelectasis and pneumonia. Using an incentive spirometer (A) aids in lung expansion but does not directly support coughing. Ambulation (B) promotes circulation but does not address respiratory concerns. Maintaining a supine position with an abdominal binder (C) may restrict diaphragmatic movement and increase the risk of respiratory complications.
A client in the late stage of inhalation anthrax requires a plan of care. What is appropriate to include in the plan of care?
- A. Provide respiratory support.
- B. Place the client in droplet isolation.
- C. Administer antihypertensive medications.
- D. Monitor ascites.
Correct Answer: A
Rationale: Step 1: Inhalation anthrax causes severe respiratory distress.
Step 2: Providing respiratory support helps maintain oxygenation.
Step 3: Oxygen therapy or mechanical ventilation may be needed.
Step 4: This choice directly addresses the critical needs of the client.
Summary:
- B: Droplet isolation is not needed as anthrax is not transmitted person-to-person.
- C: Antihypertensive medications are irrelevant to inhalation anthrax treatment.
- D: Ascites monitoring is not a priority in late-stage inhalation anthrax.
A client with tuberculosis is starting medication therapy with isoniazid, rifampin, and pyrazinamide. Which of the following instructions should the nurse include?
- A. Take isoniazid with an antacid.
- B. Provide a sputum specimen every 2 weeks to the clinic for testing.
- C. Expect your sputum cultures to be negative after 6 months of therapy.
- D. Drink at least 8 ounces of water when you take the pyrazinamide tablet.
Correct Answer: D
Rationale: Rationale:
Taking pyrazinamide on an empty stomach can cause stomach upset. Drinking water helps prevent this.
A: Isoniazid should be taken on an empty stomach, not with an antacid.
B: Sputum specimens are usually collected at the beginning of treatment, not every 2 weeks.
C: Negative sputum cultures might not be achieved until later in treatment, not after 6 months.