Which pulse oximetry reading indicates to the nurse that the client has normal tissue oxygenation?
- A. 80 to 90 mm Hg
- B. 95 to 100 mm Hg
- C. 80% to 85%
- D. 95% to 100%
Correct Answer: D
Rationale: A pulse oximetry reading of 95% to 100% indicates normal tissue oxygenation, reflecting adequate oxygen saturation.
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The nurse is planning the care of a client diagnosed with asthma and has written a problem of 'anxiety.' Which nursing intervention should be implemented?
- A. Remain with the client.
- B. Notify the health-care provider.
- C. Administer an anxiolytic medication.
- D. Encourage the client to drink fluids.
Correct Answer: A
Rationale: Remaining with the client (A) reduces anxiety through presence and reassurance. Notification (B), anxiolytics (C), and fluids (D) are secondary or unrelated.
After a chest tube has been inserted to treat the client's pneumothorax, which finding indicates that the chest tube is functioning correctly?
- A. The water in the suction control chamber is bubbling.
- B. The water seal chamber has continuous vigorous bubbling.
- C. The drainage system is positioned upright.
- D. The client reports relief of chest pain.
Correct Answer: D
Rationale: Relief of chest pain indicates the chest tube is effectively re-expanding the lung and resolving the pneumothorax.
Which clinical manifestation should the nurse expect to assess in the client recently diagnosed with COPD?
- A. Clubbing of the client's fingers.
- B. Infrequent respiratory infections.
- C. Chronic sputum production.
- D. Nonproductive hacking cough.
Correct Answer: C
Rationale: Chronic sputum production (C) is a hallmark of COPD (chronic bronchitis). Clubbing (A) is late-stage, infections (B) are frequent, and nonproductive cough (D) is atypical.
The nurse is planning the activities for the client diagnosed with asbestosis. Which activity should the nurse schedule at 0900 if breakfast is served at 0800?
- A. Assist with the client's bath and linen change.
- B. Administer an inhalation bronchodilator treatment.
- C. Provide the client with a one (1)-hour rest period.
- D. Have respiratory therapy perform chest physiotherapy.
Correct Answer: B
Rationale: Bronchodilator treatment (B) at 0900 optimizes lung function early in the day for asbestosis patients, who have restrictive lung disease. Bathing (A) is less urgent. A rest period (C) may be needed later, not immediately post-breakfast. Chest physiotherapy (D) is typically scheduled later to avoid postprandial discomfort.
A patient taking Isoniazid (INH) should be monitored for what deficiency?
- A. Vitamin C
- B. Calcium
- C. Vitamin B6
- D. Potassium
Correct Answer: C
Rationale: Isoniazid can cause peripheral neuropathy due to vitamin B6 (pyridoxine) deficiency. Patients are often given B6 supplements and monitored for this deficiency.
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