Nokea
Which observation best indicates that a client with a pneumothorax is developing a tension pneumothorax?
- A. The trachea is deviated.
- B. The client is coughing.
- C. The chest is asymmetrical.
- D. The client reports sharp pain.
Correct Answer: A
Rationale: Tracheal deviation is a hallmark sign of tension pneumothorax, indicating mediastinal shift due to increased intrathoracic pressure.
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Which explanation to the client by the nurse regarding the use of antibiotics is best?
- A. Antibiotics are ineffective in treating viral infections.
- B. Antibiotics are ineffective after cold symptoms develop.
- C. Antibiotics only prevent the spread of colds to others.
- D. Antibiotics are used only for immunosuppressed individuals.
Correct Answer: A
Rationale: Head colds are typically caused by viruses, and antibiotics are effective against bacterial infections, not viral ones.
After administering the first puff of medication, what client action demonstrates proper use of the inhaler?
- A. The client depresses the canister a second time before exhaling.
- B. The client holds his or her breath for up to 10 seconds before exhaling.
- C. The client cleans the mouthpiece with a clean paper tissue or cloth.
- D. The client bends from the waist to increase the exhaled volume.
Correct Answer: B
Rationale: Holding the breath for up to 10 seconds after inhaling allows the medication to deposit in the lungs effectively.
The nurse is assessing the client with COPD. Which health promotion information is most important for the nurse to obtain?
- A. Number of years the client has smoked.
- B. Risk factors for complications.
- C. Ability to administer inhaled medication.
- D. Willingness to modify lifestyle.
Correct Answer: C
Rationale: Correct inhaler use (C) ensures effective COPD management, a priority for health promotion. Smoking history (A), risk factors (B), and lifestyle (D) are important but secondary.
A farmer who has had a cough for several months has noticed a lack of energy lately. He is being tested for histoplasmosis. Which factor reported by the client would be most related to the diagnosis of histoplasmosis?
- A. He drinks raw milk.
- B. He cleans chicken houses.
- C. He handles fertilizer frequently.
- D. He stepped on a rusty nail recently.
Correct Answer: B
Rationale: Cleaning chicken houses exposes the client to bird droppings, a common source of Histoplasma capsulatum, the fungus causing histoplasmosis.
You are assessing your newly admitted patients who are all presenting with atypical signs and symptoms of a possible lung infection. The physician suspects tuberculosis. So, therefore, the patients are being monitored and tested for the disease. Select all the risk factors below that increases a patient's risk for developing tuberculosis:
- A. Diabetes
- B. Liver failure
- C. Long-term care resident
- D. Inmate
- E. IV drug user
- F. HIV
- G. U.S. resident
Correct Answer: A,C,D,E,F
Rationale: Risk factors for tuberculosis include conditions or environments that weaken the immune system or increase exposure: diabetes , long-term care residency , incarceration , IV drug use , and HIV . Liver failure is not a direct risk factor, and being a U.S. resident is not specific enough.