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Which of the following statements is incorrect about a patient with dysphagia?
- A. The patient will find pureed or soft foods, such as custards, easier to swallow than water
- B. Fowler's or semi Fowler's position reduces the risk of aspiration during swallowing
- C. The patient should always feed himself
- D. The nurse should perform oral hygiene before assisting with feeding
Correct Answer: C
Rationale: The incorrect statement is that 'The patient should always feed himself.' Patients with dysphagia may require assistance with feeding due to difficulty in swallowing safely. It is essential to provide appropriate support and supervision during meal times to prevent complications such as aspiration or inadequate nutrition intake.
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After 5 days of diuretic therapy with 20mg of furosemide (Lasix) daily, a patient begins to exhibit fatigue, muscle cramping, and muscle weakness. These symptoms probably indicate that the patient is experiencing:
- A. Hypokalemia
- B. Hyperkalemia
- C. Anorexia
- D. Dysphagia
Correct Answer: A
Rationale: The symptoms of fatigue, muscle cramping, and muscle weakness in a patient after starting furosemide therapy are indicative of hypokalemia. Furosemide is a loop diuretic that can lead to potassium depletion, causing hypokalemia. Hypokalemia can manifest with muscle weakness, cramps, and fatigue due to alterations in neuromuscular function and decreased ATP production.
A patient presents with an exacerbation of chronic obstructive pulmonary disease (COPD) characterized by shortness of breath, orthopnea, thick, tenacious secretions, and a dry hacking cough. An appropriate nursing diagnosis would be:
- A. Ineffective airway clearance related to thick, tenacious secretions.
- B. Ineffective airway clearance related to dry, hacking cough.
- C. Ineffective individual coping with COPD.
- D. Pain related to immobilization of affected leg.
Correct Answer: A
Rationale: The patient's symptoms of shortness of breath, orthopnea, thick, tenacious secretions, and a dry hacking cough all point towards a potential airway clearance issue. This makes option A, 'Ineffective airway clearance related to thick, tenacious secretions,' the most appropriate nursing diagnosis. It directly addresses the thick secretions and suggests a potential cause of the breathing difficulty the patient is experiencing.
What is the appropriate needle size for insulin injection?
- A. 18G, 1 ½" long
- B. 22G, 1" long
- C. 22G, 1 ½" long
- D. 25G, 5/8" long
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Why is a precise amount of oxygen necessary for a patient with COPD to prevent which complication?
- A. Cardiac arrest related to increased partial pressure of carbon dioxide in arterial blood (PaCO2)
- B. Circulatory overload due to hypervolemia
- C. Respiratory excitement
- D. Inhibition of the respiratory hypoxic stimulus
Correct Answer: D
Rationale: In patients with COPD, the respiratory drive is often stimulated by low oxygen levels. Administering too much oxygen can inhibit this hypoxic drive, leading to respiratory depression and potential respiratory failure. Therefore, it is crucial to carefully regulate the oxygen therapy to prevent the inhibition of the respiratory hypoxic stimulus in COPD patients.
Which deficiency is most commonly seen in individuals with alcohol use disorder?
- A. Thiamine
- B. Riboflavin
- C. Pyridoxine
- D. Pantothenic acid
Correct Answer: A
Rationale: Thiamine deficiency, also known as Vitamin B1 deficiency, is the most common vitamin deficiency seen in individuals with alcohol use disorder. Chronic alcohol consumption can lead to decreased thiamine absorption and utilization, as well as poor dietary intake. Thiamine deficiency can result in serious neurological complications, such as Wernicke-Korsakoff syndrome, making it essential to address thiamine supplementation in individuals with alcohol use disorder.