Nokea
Which of the following interventions should the nurse anticipate in a client who has been diagnosed with acute respiratory distress syndrome (ARDS)?
- A. Tracheostomy.
- B. Use of a nasal cannula.
- C. Mechanical ventilation.
- D. Insertion of a chest tube.
Correct Answer: C
Rationale: ARDS with severe hypoxemia typically requires mechanical ventilation to support oxygenation and ventilation. Tracheostomy is considered later. Nasal cannula is inadequate. Chest tubes are for pneumothorax, not ARDS.
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Upon assessment of third degree heart block on the monitor, the nurse should first:
- A. Call a code.
- B. Begin cardiopulmonary resuscitation.
- C. Have transcutaneous pacing ready at the bedside.
- D. Prepare for defibrillation.
Correct Answer: C
Rationale: Third-degree heart block may require pacing. Having transcutaneous pacing ready is the first step to manage symptomatic bradycardia.
The client's family asks why the client who had a splenectomy has a nasogastric (NG) tube. An NG tube is used to:
- A. Move the stomach away from where the spleen was removed.
- B. Irrigate the operative site.
- C. Decrease abdominal distention.
- D. Assess for the gastric pH as peristalsis returns.
Correct Answer: C
Rationale: An NG tube is used post-splenectomy to decompress the stomach and decrease abdominal distention, which can reduce pressure on the surgical site and promote healing. It does not move the stomach, irrigate the site, or assess gastric pH.
The nurse is caring for a client in skeletal traction for a femoral fracture. Which assessment should be prioritized?
- A. Skin integrity at pin sites.
- B. Room temperature control.
- C. Frequency of bowel movements.
- D. Client's emotional status.
Correct Answer: A
Rationale: Pin site infections are a common complication in skeletal traction, requiring prioritized assessment.
Which of the following statements indicates the client understands the expected course of Ménière'sdisease?
- A. The disease process will gradually extend to the eyes.
- B. Control of the episodes is usually possible, but a cure is not yet available.
- C. Continued medication therapy will cure the disease.
- D. Bilateral deafness is an inevitable outcome of the disease.
Correct Answer: B
Rationale: Ménière'sdisease is a chronic condition with no cure, but episodes can often be managed with medications, diet, and lifestyle changes, though hearing loss may progress over time.
Good dental care is an important measure in reducing the risk of endocarditis. A teaching plan to promote good dental care in a client with mitral stenosis should include demonstration of the proper use of:
- A. A manual toothbrush.
- B. An electric toothbrush.
- C. An irrigation device.
- D. Dental floss.
Correct Answer: D
Rationale: Dental floss removes plaque and debris, reducing the risk of oral infections that could lead to endocarditis in mitral stenosis.