Nokea
Which of the following patients are MOST at risk for developing pneumonia? Select-all-that-apply:
- A. A 53 year old female recovering from abdominal surgery.
- B. A 69 year old patient who recently received the pneumococcal conjugate vaccine.
- C. A 42 year old male with COPD and is on continuous oxygen via nasal cannula.
- D. A 8 month old with RSV (respiratory syncytial virus) infection.
Correct Answer: A,C,D
Rationale: Patients recovering from surgery are at risk due to immobility and impaired cough reflex, those with COPD have chronic lung disease increasing susceptibility, and infants with RSV are prone to secondary bacterial pneumonia. The vaccinated patient has reduced risk due to immunity.
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The client diagnosed with lung cancer is being discharged. Which statement made by the client indicates more teaching is required?
- A. It doesn't matter if I smoke now. I already have cancer.
- B. I should see the oncologist at my scheduled appointment.
- C. If I begin to run a fever, I should notify the HCP.
- D. I should plan for periods of rest throughout the day.
Correct Answer: A
Rationale: Continued smoking (A) worsens lung cancer outcomes, indicating a need for teaching. Follow-ups (B), fever reporting (C), and rest (D) are correct.
Which task is most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?
- A. Feed a client who is postoperative tonsillectomy the first meal of clear liquids.
- B. Encourage the client diagnosed with a cold to drink a glass of orange juice.
- C. Obtain a throat culture on a client diagnosed with bacterial pharyngitis.
- D. Escort the client diagnosed with laryngitis outside to smoke a cigarette.
Correct Answer: B
Rationale: Encouraging juice intake (B) is within UAP scope and safe. Feeding post-tonsillectomy (A) risks bleeding, throat cultures (C) require training, and smoking (D) is contraindicated.
Which assessment data indicate to the nurse the chest tubes inserted three (3) days ago have been effective in treating the client with a hemothorax?
- A. Gentle bubbling in the suction compartment.
- B. No fluctuation (tidaling) in the water-seal compartment.
- C. The drainage compartment has 250 mL of blood.
- D. The client is able to deep breathe without any pain.
Correct Answer: B
Rationale: No tidaling (B) indicates lung re-expansion, showing effective hemothorax treatment. Bubbling (A) suggests air leak, drainage (C) is expected, and pain-free breathing (D) is secondary.
Which instruction regarding the prescribed medication is most appropriate to tell this client?
- A. Do not take the drug more frequently than prescribed.
- B. Avoid taking the medication before going to sleep.
- C. Drink more fluid throughout the day.
- D. Warm the cough syrup to make it more palatable.
Correct Answer: C
Rationale: Drinking more fluids enhances the expectorant effect of guaifenesin, helping to thin and expel mucus.
Which statement made by the client indicates the nurse's discharge teaching is effective for the client diagnosed with COPD?
- A. I need to get an influenza vaccine each year, even when there is a shortage.
- B. I need to get a vaccine for pneumonia each year with my influenza shot.
- C. If I reduce my cigarettes to six (6) a day, I won't have difficulty breathing.
- D. I need to restrict my drinking liquids to keep from having so much phlegm.
Correct Answer: A
Rationale: Annual flu vaccines (A) reduce COPD exacerbation risk, even in shortages. Pneumonia vaccines (B) are not yearly, smoking reduction (C) is insufficient, and fluid restriction (D) is incorrect.