Nokea
Which of the following explanations by the nurse will help a patient understand what to expect during a bronchoscopy?
- A. “The physician will place a small tube through your nose or mouth and into the bronchi to look at your airways.”
- B. “You will breathe a radioactive substance that will show diseased areas in your lungs.”
- C. “You will need to drink a thick white liquid, which will be opaque on the x-rays.”
- D. “A die will be injected to help visualize the structures of the bronchioles. Do you have any allergies?”
Correct Answer: A
Rationale: The correct answer is A because it accurately describes the procedure of bronchoscopy. The nurse's explanation should focus on the insertion of a small tube through the nose or mouth into the bronchi to visualize the airways. This information helps the patient understand the basic process and what to expect during the procedure.
Choice B is incorrect as bronchoscopy does not involve breathing a radioactive substance to show diseased areas in the lungs. Choice C is also incorrect as there is no requirement to drink a thick white liquid for bronchoscopy. Choice D is incorrect as dye injection is not a standard part of bronchoscopy, and asking about allergies to dye is irrelevant in this context.
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A patient’s serum sodium is within normal range. The nurse estimates that serum osmolality should be:
- A. Less than 136mOsm/kg
- B. Greater than 408mOsm/kg
- C. 280 to 295mOsm/kg
- D. 350 to 544mOsm/kg
Correct Answer: C
Rationale: The correct answer is C (280 to 295mOsm/kg) because serum osmolality is primarily determined by sodium, glucose, and blood urea nitrogen levels. Normal serum sodium range is 135-145 mEq/L, which corresponds to an osmolality range of 280-295 mOsm/kg. Choices A and B are incorrect as they do not align with normal serum sodium levels. Choice D is incorrect as it includes an excessively wide range that is not consistent with normal osmolality values.
Which points should a nurse includes in the discharge teaching plan for a client after cardiac surgery?
- A. Avoid showers and take tub bath until all incisions are healed
- B. Notify the physician if a painless lump is felt at the top of the chest incision
- C. Continue to wear support hose or elastic stockings during the night and remove them during the day
- D. Sexual relations typically can be resumed in 2-4 weeks depending on tolerance for activity
Correct Answer: B
Rationale: The correct answer is B because it addresses the importance of notifying the physician about a painless lump at the top of the chest incision, which could indicate a serious complication like a seroma or hematoma. This is crucial for early detection and intervention.
A is incorrect because showers are generally allowed after cardiac surgery as long as the incisions are kept clean and dry.
C is incorrect because support hose or elastic stockings are typically recommended to be worn during the day and removed at night to prevent swelling and promote circulation.
D is incorrect because resuming sexual relations after cardiac surgery should be based on individual recovery and should be discussed with the healthcare provider, rather than a standard timeframe.
A patient has orders to receive 1 L (1000 mL) of 5% dextrose and lactated Ringer’s solution to be infused over 8 hours. How many millilitres will be infused per hour?
- A. 80
- B. 100
- C. 125
- D. 150
Correct Answer: C
Rationale: The correct answer is C: 125 mL/h. To calculate the infusion rate per hour, we divide the total volume (1000 mL) by the total time in hours (8 hours). 1000 mL / 8 hours = 125 mL/h. This ensures a consistent and accurate infusion rate throughout the 8-hour period.
Choice A (80 mL/h) is incorrect because it underestimates the infusion rate. Choice B (100 mL/h) is incorrect because it does not divide the total volume by the total time correctly. Choice D (150 mL/h) is incorrect because it overestimates the infusion rate.
The nurse interprets this as?
- A. Respiratory acidosis
- B. Metabolic acidosis
- C. Respiratory alkalosis
- D. Metabolic alkalosis
Correct Answer: C
Rationale: The nurse interprets this as respiratory alkalosis because the patient is likely experiencing hyperventilation, leading to a decrease in CO2 levels and respiratory alkalosis. This is indicated by an increase in pH and a decrease in PaCO2 on arterial blood gas analysis. Metabolic acidosis (choice B) is characterized by low pH and low bicarbonate levels, not seen in this scenario. Respiratory acidosis (choice A) is characterized by high PaCO2 levels and low pH, which is not the case here. Metabolic alkalosis (choice D) is characterized by high pH and high bicarbonate levels, which is not consistent with the patient's presentation.
A client with a nagging cough makes an appointment to see the physician after reading that this symptom is one of the seven warning signs of cancer. What is another warning sign of cancer?
- A. Persistent nausea
- B. Indigestion
- C. Rash
- D. Chronic ache or pain
Correct Answer: D
Rationale: The correct answer is D: Chronic ache or pain. Persistent cough and chronic ache or pain are both common warning signs of cancer. Chronic pain can be a symptom of various types of cancer, signaling the presence of a tumor or cancerous growth. It is important for the client to seek medical evaluation to rule out any underlying serious condition.
A: Persistent nausea is not typically considered a common warning sign of cancer. While it can be a symptom in certain types of cancer or due to treatment side effects, it is not as prominent as chronic ache or pain.
B: Indigestion is a common symptom that can be caused by various non-cancer-related issues such as dietary habits, stress, or gastrointestinal disorders. It is not typically considered a direct warning sign of cancer.
C: Rash is generally not a common warning sign of cancer. Rashes are more commonly associated with skin conditions, allergic reactions, or infections rather than being an indicator of cancer.