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Which of the ff is a sign or symptom of asthma?
- A. Production of abnormally thick, sticky mucus in lungs
- B. Faulty transport of sodium in lung cells
- C. Paroxysms or shortness of breath
- D. Altered electrolyte balance in the sweat glands
Correct Answer: C
Rationale: Paroxysms, or sudden attacks, of shortness of breath are a common sign or symptom of asthma. Asthma is a chronic respiratory condition characterized by inflammation and narrowing of the airways, which leads to difficulty breathing. During an asthma attack, individuals may experience sudden and severe shortness of breath, often accompanied by wheezing, coughing, and chest tightness. These paroxysms of breathlessness are a hallmark feature of asthma and indicate the presence of airway inflammation and constriction.
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A 4-year-old weighing 15 kg produces 150 mL of urine in 10 hours. What should the nurse do?
- A. Notify the physician; urine output is too low.
- B. Encourage increased oral intake.
- C. Record the urine output in the chart.
- D. Administer IV fluids to rehydrate.
Correct Answer: C
Rationale: Expected urine output is 0.5-1 mL/kg/hr. For a 15-kg child over 10 hours, 75-150 mL is within normal limits.
The child begins to understand right and left by age of
- A. 3 yr
- B. 4 yr
- C. 5 yr
- D. 6 yr
Correct Answer: C
Rationale: Understanding right and left typically develops around age 5.
To prevent leakage of fluid in the thoracic cavity, how will you position the client after thoracentesis?
- A. Place flat in bed
- B. Turn on the affected side
- C. Turn on the unaffected side
- D. On bed rest SENSORY DISORDERS
Correct Answer: C
Rationale: After thoracentesis, it is important to position the client on the unaffected side to prevent leakage of fluid into the thoracic cavity. Placing the client on the unaffected side helps to promote proper drainage and reduce the risk of complications such as pneumothorax or fluid leakage. This position also allows for adequate lung expansion and facilitates proper re-expansion of the lung on the side where the fluid was removed. It is essential to follow this positioning to optimize outcomes and minimize risks associated with the procedure.
An oncology nurse educator is speaking to a women's group about breast cancer. Questions and comments from the audience reveal a misunderstanding of some aspects of the disease. Various members of the audience have made all of the following statements. Which one is accurate?
- A. Mammography is the most reliable method for detecting breast cancer.
- B. Breast cancer is the leading killer of women of childbearing age.
- C. Breast cancer requires a mastectomy.
- D. Men can develop breast cancer.
Correct Answer: D
Rationale: While all the statements made by the audience members may have been common misconceptions, the only one that is accurate is that men can develop breast cancer. Although it is less common in men than in women, breast cancer can still affect males. It is important for everyone to be aware of the risks and symptoms of breast cancer, regardless of gender.
Maintaining the infusion rate of hyperalimentation solutions is a nursing responsibility. What side effects would you anticipate from too rapid infusion rate?
- A. Cellular dehydration and potassium
- B. Hypoglycemia and hypovolemia
- C. Potassium excess and CHF
- D. Circulatory overload and hypoglycemia SITUATION: In the recall of the fluids and electrolytes, the nurse should be able to understand the calculations and other conditions related to loss or retention.
Correct Answer: D
Rationale: Too rapid infusion of hyperalimentation solutions can lead to circulatory overload due to the rapid volume expansion, which can strain the heart and lead to fluid overload. This can manifest as symptoms such as shortness of breath, crackles in the lungs, and edema. Additionally, a rapid infusion rate can cause a sudden surge in glucose levels, potentially leading to hypoglycemia due to increased insulin release in response to the elevated glucose levels. It is important for the nurse to maintain a careful and appropriate infusion rate to prevent these complications and ensure patient safety.