Nokea
When the LPN is assisting the patient to use an incentive spirometer, which of the following actions by the patient indicates that the patient needs further teaching on how to use the spirometer?
- A. Taking two normal breaths before use.
- B. Sitting upright before use.
- C. Inhaling deeply to reach target.
- D. Exhaling deeply to reach target.
Correct Answer: D
Rationale: When using an incentive spirometer, the patient should inhale deeply to reach the target volume indicated by the marker. Exhaling deeply does not achieve the objective of the incentive spirometer, which is to encourage deep inhalation. If the patient exhales deeply to reach the target, further teaching and clarification about the proper technique of using the spirometer are needed. The correct technique involves inhaling deeply to expand the lungs and help improve lung function.
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A nurse is preparing to administer an angiotensin-converting enzyme (ACE) inhibitor. Which drug should the nurse administer?
- A. Captopril (Capoten)
- B. Furosemide (Lasix)
- C. Spironolactone (Aldactone)
- D. Chlorothiazide (Diuril)
Correct Answer: A
Rationale: Angiotensin-converting enzyme (ACE) inhibitors, such as captopril, work by inhibiting the conversion of angiotensin I to angiotensin II. This leads to vasodilation, reduced aldosterone secretion, and ultimately decreases blood pressure. ACE inhibitors are commonly used in the management of hypertension, heart failure, and post-myocardial infarction. In this case, the nurse should administer captopril as it is an ACE inhibitor, while the other options (B. Furosemide, C. Spironolactone, D. Chlorothiazide) are not ACE inhibitors and have different mechanisms of action.
About 500 children have just been exposed to radiation from a nuclear power plant accident. The most appropriate first step in your treatment of these children should be to
- A. prescribe potassium iodide to protect the thyroid
- B. order thyroid function tests
- C. order complete blood counts (CBCs)
- D. do nothing acutely; evaluate in 4-6 weeks
Correct Answer: A
Rationale: Potassium iodide can protect the thyroid from radioactive iodine exposure, which is a critical first step in radiation exposure.
The nurse evaluates a certified nursing assistant. Which of the following actions by the CAN demonstrates understanding of standard precautions?
- A. Wears gloves during all client contact
- B. Cleans blood spills with soap and water
- C. Pours bulk blood and other secretions down a drain connected to a sanitary sewer
- D. Carries blood sample to the lab in an open basket
Correct Answer: A
Rationale: The correct action that demonstrates understanding of standard precautions is wearing gloves during all client contact. Standard precautions are designed to prevent the transmission of infectious agents from both recognized and unrecognized sources of infection. Wearing gloves during client contact helps protect both the patient and the healthcare worker from potential infection transmission through contact with bodily fluids, skin, mucous membranes, and non-intact skin. Cleaning blood spills with soap and water is also part of standard precautions to prevent the spread of infection. However, pouring bulk blood and other secretions down a drain connected to a sanitary sewer and carrying a blood sample to the lab in an open basket do not align with standard precautions and could pose infection control risks.
An adolescent patient, who has pelvic inflammatory disease (PID), inquires about the effects of the disease on their ability to bear children. What is the pediatric nurse's best response?
- A. The occurrence of spontaneous abortion during pregnancy increases with PID.
- B. There is an increased risk for ectopic pregnancy or infertility.
- C. There is an increased risk of placenta previa.
- D. There should be no problems with your ability to conceive.
Correct Answer: B
Rationale: PID can lead to scarring of the fallopian tubes, increasing the risk of ectopic pregnancy or infertility.
Regarding the physical growth of middle childhood (6-11 yr), all are true EXCEPT
- A. 3-3.5 kg weight increment/yr
- B. 6-7 cm height increment/yr
- C. brain myelinization stops by 8 yr
- D. deciduous tooth falls by 6 yr
Correct Answer: C
Rationale: Brain myelinization continues beyond 8 years.