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A patient with interstitial lung disease (ILD) develops progressive dyspnea, non-productive cough, and fine inspiratory crackles on auscultation. High-resolution computed tomography (HRCT) of the chest reveals diffuse reticular opacities and traction bronchiectasis. Which of the following ILD subtypes is most likely to present with these clinical and radiographic features?
- A. Idiopathic pulmonary fibrosis (IPF)
- B. Sarcoidosis
- C. Hypersensitivity pneumonitis (HP)
- D. Connective tissue disease-associated ILD
Correct Answer: A
Rationale: The clinical presentation of a patient with progressive dyspnea, non-productive cough, fine inspiratory crackles, and HRCT findings of diffuse reticular opacities and traction bronchiectasis is highly suggestive of idiopathic pulmonary fibrosis (IPF). IPF is a specific subtype of ILD characterized by progressive scarring of the lung tissue, leading to the symptoms mentioned above. The presence of reticular opacities and traction bronchiectasis on HRCT is a typical finding in IPF.
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A patient presents with pallor, fatigue, and dyspnea on exertion. Laboratory tests reveal a low hemoglobin level, low MCV, and elevated red blood cell distribution width (RDW). Which of the following conditions is most likely to cause these findings?
- A. Iron deficiency anemia
- B. Thalassemia
- C. Anemia of chronic disease
- D. Megaloblastic anemia
Correct Answer: A
Rationale: #NAME?
A client has undergone a lymph node biopsy. The nurse anticipates that the report will reveal which result if the client has Hodgkin's Lymphoma?
- A. Reed-Sternberg cells
- B. Philadelphia chromosome
- C. Epstein-barr virus
- D. Herpes simplex virus
Correct Answer: A
Rationale: Reed-Sternberg cells are large, abnormal lymphocytes that are characteristic of Hodgkin's Lymphoma. They are typically found in the affected lymph nodes of individuals with Hodgkin's Lymphoma when examined under a microscope. Identifying Reed-Sternberg cells in a lymph node biopsy is a key diagnostic feature of Hodgkin's Lymphoma. This distinguishes Hodgkin's Lymphoma from other types of lymphomas that do not have Reed-Sternberg cells.
A postpartum client presents with persistent, severe abdominal pain, distention, and absent bowel sounds. Which nursing action is most appropriate?
- A. Encouraging the client to ambulate to promote bowel function
- B. Providing a heating pad to alleviate abdominal discomfort
- C. Notifying the healthcare provider immediately
- D. Administering a laxative to promote bowel evacuation
Correct Answer: C
Rationale: The most appropriate nursing action in this situation is to notify the healthcare provider immediately. The symptoms the postpartum client is experiencing - persistent, severe abdominal pain, distention, and absent bowel sounds - are concerning and could indicate a serious underlying issue such as bowel obstruction or other complications. Prompt communication with the healthcare provider is crucial to ensure the client receives the necessary assessment, intervention, and treatment. Encouraging ambulation, providing a heating pad, or administering a laxative are not appropriate actions in this case without first consulting with the healthcare provider due to the severity and potential complexity of the client's symptoms.
Before the education plan of the staff nurse can be finalized and implemented, it is best that it is reviewed by the
- A. Nurse supervisor
- B. Head nurse
- C. Medical Director
- D. Chief nurse
Correct Answer: A
Rationale: Before finalizing and implementing the education plan for the staff nurse, it is important to have the plan reviewed by the nurse supervisor. The nurse supervisor is directly responsible for overseeing the staff nurses and their education and training needs. They have a good understanding of the staff nurse's current skills, areas for improvement, and training requirements. By involving the nurse supervisor in the review process, you can ensure that the education plan is aligned with the overall goals and needs of the nursing staff and the department. Additionally, the nurse supervisor can provide valuable input and insights to help tailor the education plan to meet the specific needs of the staff nurses under their supervision.
A patient is prescribed an opioid analgesic for the management of acute pain. Which adverse effect should the nurse monitor closely in the patient?
- A. Hypertension
- B. Hypoglycemia
- C. Respiratory depression
- D. Hyperkalemia
Correct Answer: C
Rationale: Opioid analgesics are known to suppress the respiratory centers in the brain, leading to respiratory depression as a side effect. This adverse effect is particularly dangerous and potentially life-threatening, especially in patients who are opioid-naive or when high doses are administered. Therefore, it is crucial for the nurse to closely monitor the patient's respiratory rate, depth, and effort while on opioid analgesic therapy to detect early signs of respiratory depression and intervene promptly to prevent complications. Hypertension, hypoglycemia, and hyperkalemia are not commonly associated with opioid analgesics.