Nokea
Which one of the following four clients is most likely to tolerate pain best?
- A. a client with rheumatoid arthritis
- B. a client who has terminal cancer in stage 1 of grief
- C. an athlete having a knee surgery to prolong his career
- D. a client who has a migraine headache
Correct Answer: C
Rationale: An athlete undergoing knee surgery likely tolerates pain best, motivated by career goals, unlike chronic arthritis, cancer grief, or migraines. Nurses consider this in pain management.
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The nurse uses the Glasgow Coma Scale to assess a client with a head injury. Which Glasgow Coma Scale score indicates that the client is in a coma?
- A. 6
- B. 9
- C. 12
- D. 15
Correct Answer: A
Rationale: A Glasgow Coma Scale (GCS) score of 6 (A) indicates coma, defined as ≤8, reflecting minimal responsiveness (eye, verbal, motor). Scores of 9 (B) and 12 (C) suggest moderate injury. 15 (D) is normal. A is correct. Rationale: GCS ≤8 signifies severe brain dysfunction, often requiring intubation, a standard threshold in neurocritical care for coma classification and management.
Which of the following statement best describe quality improvement?
- A. A one-time fix
- B. Ongoing effort to enhance care
- C. A punishment for errors
- D. A financial strategy
Correct Answer: B
Rationale: Quality improvement is an ongoing effort to enhance care (B), per QI models e.g., PDSA cycles. Not one-time (A), not punishment (C), not just finance (D) continuous. B best defines QI's iterative nature, making it correct.
The nurse working in the community is assigned to the care of several clients. Which client(s) may require assistance to overcome barriers to accessing adequate care?
- A. A student entering a local university
- B. A client who is a migrant and works on a farm
- C. An older adult client living independently
- D. A client who has been unemployed for 6 months
Correct Answer: B
Rationale: Barriers to healthcare access often hit vulnerable groups hardest, requiring nursing intervention. A migrant farm worker faces language, mobility, and economic hurdles, limiting care access e.g., no insurance or transport. An older adult living alone may struggle with mobility, health literacy, or isolation, delaying treatment. An unemployed client, lacking income or coverage, often skips care due to cost, risking worsening conditions. A student entering university or an employed pregnant client typically has fewer systemic barriers students may access campus health, employed clients insurance. Nursing must target the migrant, elderly, and jobless, addressing disparities poverty, age, ethnicity ensuring equitable care. This reflects nursing's equity mission, bridging gaps for those society sidelines, enhancing health outcomes through advocacy and resource linkage.
Which of the following meal choices is suitable for a 6-month-old infant?
- A. Egg white, formula, and orange juice
- B. Apple juice, carrots, whole milk
- C. Rice cereal, apple juice, formula
- D. Melba toast, egg yolk, whole milk
Correct Answer: C
Rationale: Rice cereal, apple juice, and formula suit a 6-month-old, aligning with early solid introduction gluten-free, digestible, and safe, per pediatric guidelines. Egg whites risk allergies, whole milk isn't recommended before 1 year, and melba toast is a choking hazard. Nurses advise this menu to support growth, avoiding allergens or hard foods, ensuring nutritional balance for this developmental stage.
A client with chronic obstructive pulmonary disease (COPD) is prescribed long-term oxygen therapy. What is the most important nursing consideration for this client?
- A. Assessing for signs of oxygen toxicity
- B. Monitoring the client's carbon dioxide levels
- C. Promoting proper humidification of oxygen
- D. Ensuring an adequate supply of oxygen
Correct Answer: B
Rationale: Monitoring carbon dioxide levels (B) is critical in COPD clients on long-term oxygen therapy, as they may retain CO2, risking respiratory acidosis if oxygen suppresses their hypoxic drive (target SpO2 88-92%). Oxygen toxicity (A) is rare at low flows used in COPD. Humidification (C) enhances comfort but isn't the priority. Oxygen supply (D) is a general need, not COPD-specific. CO2 monitoring via ABGs or capnography ensures safe titration, preventing hypercapnia, a key consideration per COPD management guidelines like GOLD standards.