Nokea
Which nursing explanation identifies the primary rationale for administering aminophylline?
- A. Aminophylline relieves persistent coughing.
- B. Aminophylline reduces mucosal edema.
- C. Aminophylline dilates the bronchial airways.
- D. Aminophylline thins respiratory secretions.
Correct Answer: C
Rationale: Aminophylline is a bronchodilator that dilates bronchial airways, improving airflow in COPD clients.
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During the preoperative period, which nursing action will be of greatest priority for a person who is to have a laryngectomy?
- A. Establish a means of communication.
- B. Prepare the bowel by administering enemas until clear.
- C. Teach the client to use an artificial larynx.
- D. Demonstrate the technique for suctioning a laryngectomy tube.
Correct Answer: A
Rationale: Establishing a means of communication is the highest priority preoperatively, as the client will lose the ability to speak post-laryngectomy.
A patient receiving medical treatment for an active tuberculosis infection asks when she can starting going out in public again. You respond that she is no longer contagious when:
- A. She has 3 negative sputum cultures
- B. Her signs and symptoms improve
- C. She has completed the full medication regime
- D. Her chest x-ray is normal
- E. She has been on tuberculosis medications for about 3 weeks
Correct Answer: A
Rationale: A patient with active TB is considered non-contagious after three consecutive negative sputum cultures, indicating no viable bacteria. Symptom improvement, medication duration, or normal X-rays alone do not confirm non-contagiousness.
You're educating a patient about Warfarin (Coumadin) and how it is used to treat blood clots. Which statements by the patient require you to re-educate them about how this medication works? Select all that apply:
- A. This medication will help dissolve the blood clot.
- B. This medication will prevent another blood clot from forming.
- C. This medication will help prevent the blood clot from becoming bigger in size.
- D. This medication starts working immediately after the first dose.
Correct Answer: A,D
Rationale: Warfarin (Coumadin) does NOT dissolve blood clots. It prevents blood clots from forming, and if one is present, it will help prevent it from becoming bigger. If the blood clot becomes bigger it may break off and travel in blood circulation. This can lead to a pulmonary embolism, heart attack, or stroke. Warfarin (Coumadin) does NOT start working immediately. It takes about 3-5 days of scheduled doses to start achieving a therapeutic INR level. It is very common that a patient will be on Heparin while taking Warfarin until INR levels are therapeutic.
The day shift charge nurse on a medical unit is making rounds after report. Which client should be seen first?
- A. The 65-year-old client diagnosed with tuberculosis who has a sputum specimen to be sent to the laboratory.
- B. The 76-year-old client diagnosed with aspiration pneumonia who has a clogged feeding tube.
- C. The 45-year-old client diagnosed with pneumonia who has a pulse oximetry reading of 92%.
- D. The 39-year-old client diagnosed with bronchitis who has an arterial oxygenation level of 89%.
Correct Answer: D
Rationale: SpO2 89% (D) indicates significant hypoxia, requiring immediate assessment. TB sputum (A), clogged tube (B), and SpO2 92% (C) are less urgent.
The client diagnosed with ARDS is transferred to the intensive care department and placed on a ventilator. Which intervention should the nurse implement first?
- A. Confirm that the ventilator settings are correct.
- B. Verify that the ventilator alarms are functioning properly.
- C. Assess the respiratory status and pulse oximeter reading.
- D. Monitor the client's arterial blood gas results.
Correct Answer: C
Rationale: Assessing respiratory status and SpO2 (C) ensures immediate patient stability. Ventilator settings (A), alarms (B), and ABGs (D) follow.