Nokea
Which of the ff. is the best explanation of emphysema for a newly diagnosed patient?
- A. “You have inflamed bronchioles, which causes a lot of secretions.”
- B. “Your lungs have lost some of their elasticity, and air gets trapped.”
- C. “The blood supply to your lungs is damaged, so you can’t absorb oxygen.”
- D. “You have large dilated sacs of sputum in your lungs.”
Correct Answer: B
Rationale: The correct answer is B because emphysema is characterized by the destruction of the alveoli walls, leading to a loss of elasticity in the lungs. This results in air becoming trapped in the lungs, making it difficult to exhale properly.
Explanation for why the other choices are incorrect:
A: Inflamed bronchioles causing secretions describe bronchitis, not emphysema.
C: Damage to the blood supply isn't a primary feature of emphysema; it's more about lung tissue destruction.
D: Large dilated sacs of sputum in the lungs is not an accurate description of emphysema; it's more related to bronchiectasis.
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A client with Hashimoto’s thyroiditis and a history of two myocardial infarctions and coronary artery disease is to receive levothyroxine (Synthroid). Because of the client’s cardiac history, the nurse would expect that the client’s initial dose for the thyroid replacement would be which of the following?
- A. 25 g/day, initially
- B. Delayed until after thyroid surgery
- C. 100 g/day, initially
- D. Initiated before thyroid surgery
Correct Answer: A
Rationale: The correct answer is A: 25 g/day, initially. In this scenario, the client with Hashimoto's thyroiditis and a history of cardiac issues requires a cautious approach due to the risk of exacerbating cardiac conditions with thyroid hormone replacement. Starting with a low dose of 25 µg/day allows for careful monitoring of the client's response and prevents potential adverse effects on the cardiovascular system.
Summary:
B: Delayed until after thyroid surgery - Not appropriate as the client requires thyroid replacement therapy for Hashimoto's thyroiditis.
C: 100 µg/day, initially - Too high of an initial dose and may lead to adverse cardiovascular effects.
D: Initiated before thyroid surgery - Not relevant to the client's situation as there is no indication for thyroid surgery mentioned in the question.
An unconscious patient is brought to the emergency department. Which of the following assessments should be implemented first?
- A. The client’s airway should be assessed.
- B. The nurse should determine the reason for admission.
- C. The nurse should review the client’s medications.
- D. The client’s past medical history is assessed.
Correct Answer: A
Rationale: The correct answer is A: The client’s airway should be assessed first. This is because airway management is the top priority in any emergency situation to ensure the patient can breathe. Without a patent airway, the patient's oxygenation and ventilation will be compromised, leading to serious complications or death. Choices B, C, and D are incorrect because assessing the airway takes precedence over determining the reason for admission, reviewing medications, or assessing past medical history in an unconscious patient. These other assessments are important but not as critical as securing the airway to maintain the patient's breathing and oxygenation.
The nurse knows which of the following statements about TPN and peripheral parenteral nutrition is true?
- A. TPN is usually indicated for clients needing short term (less than 3 weeks) nutritional support, whereas PPN is for long term maintenance
- B. A client needing more than 3000 calories would receive PPN, whereas TPN is given to those requiring less than 3000 calories
- C. TPN is often given to those with fluid restrictions, whereas PPN is used for those without constraints on their fluid intake
- D. TPN is given to those who need to augment oral feeding, whereas PPN is used for those who are nothing by mouth
Correct Answer: C
Rationale: The correct answer is C because TPN (Total Parenteral Nutrition) is indeed given to patients with fluid restrictions, as it provides complete nutrition including fluids, electrolytes, and nutrients. On the other hand, PPN (Peripheral Parenteral Nutrition) is used for patients without fluid restrictions as it provides partial nutrition. A is incorrect because TPN is typically for long-term use and PPN for short-term use. B is incorrect as the caloric requirement does not determine the type of parenteral nutrition. D is incorrect because both TPN and PPN can be used for patients who are unable to eat orally.
The following are known to be causes of hepatitis except:
- A. virus
- B. toxin
- C. bacteria
- D. chemicals and drugs
Correct Answer: C
Rationale: The correct answer is C: bacteria. Hepatitis is primarily caused by viruses (such as Hepatitis A, B, C), toxins (like alcohol or certain medications), and chemicals/drugs. Bacteria do not typically cause hepatitis as it is a viral infection that affects the liver. Therefore, choice C is the exception among the listed causes. Viruses directly target liver cells, toxins can damage the liver, and certain chemicals/drugs can lead to liver inflammation. Hence, bacteria do not play a significant role in causing hepatitis.
In addition to antibiotics, which of the ff. recommendations can the nurse make to increase comfort in a patient experiencing sinusitis? Choose all answers that are correct. i. Coughing and deep breathing iv. Room humidifier ii. Sinus irrigation v. Percussion and postural drainage iii. Hot moist packs vi. Semi-fowler’s position
- A. 1 ,2 and 5
- B. 1, 3, 4 and 5
- C. 3, 4 and 6
- D. 2, 4, 5 and 6
Correct Answer: D
Rationale: The correct answer is D: 2, 4, 5, and 6.
1. Room humidifier (choice 2) helps to keep the air moist, which can ease sinus pressure and discomfort.
2. Hot moist packs (choice 4) can provide relief by reducing congestion and promoting sinus drainage.
3. Percussion and postural drainage (choice 5) can help loosen mucus and improve drainage.
4. Semi-fowler's position (choice 6) can also aid in drainage and reduce sinus pressure.
Choices A, B, and C are incorrect because they do not include all the recommended interventions that can help increase comfort in a patient with sinusitis. Each of the incorrect choices is missing at least one crucial recommendation that is beneficial for managing sinusitis symptoms.