Nokea
You are assessing your newly admitted patients who are all presenting with atypical signs and symptoms of a possible lung infection. The physician suspects tuberculosis. So, therefore, the patients are being monitored and tested for the disease. Select all the risk factors below that increases a patient's risk for developing tuberculosis:
- A. Diabetes
- B. Liver failure
- C. Long-term care resident
- D. Inmate
- E. IV drug user
- F. HIV
- G. U.S. resident
Correct Answer: A,C,D,E,F
Rationale: Risk factors for tuberculosis include conditions or environments that weaken the immune system or increase exposure: diabetes , long-term care residency , incarceration , IV drug use , and HIV . Liver failure is not a direct risk factor, and being a U.S. resident is not specific enough.
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Which arterial blood gas (ABG) results support the diagnosis of acute respiratory distress syndrome (ARDS) after the client has received O2 at 10 LPM?
- A. pH 7.38, Pao2 94, Paco2 44, Hco3 24.
- B. pH 7.46, Pao2 82, Paco2 34, Hco3 22.
- C. pH 7.48, Pao2 59, Paco2 30, Hco3 26.
- D. pH 7.33, Pao2 94, Paco2 44, Hco3 20.
Correct Answer: C
Rationale: ARDS is characterized by severe hypoxemia despite high oxygen delivery. Pao2 59 (C) despite 10 LPM oxygen indicates refractory hypoxia, a hallmark of ARDS. Normal Pao2 (94 in A and D) contradicts ARDS. Pao2 82 (B) is low but not as severe as 59, making C the best indicator of ARDS.
The charge nurse is making client assignments on a medical floor. Which client should the charge nurse assign to the licensed practical nurse (LPN)?
- A. The client with pneumonia who has a pulse oximeter reading of 91%.
- B. The client with a hemothorax who has Hb of 9 g/dL and Hct of 20%.
- C. The client with chest tubes who has jugular vein distention and BP of 96/60.
- D. The client who is two (2) hours post-bronchoscopy procedure.
Correct Answer: D
Rationale: Post-bronchoscopy (D) is stable for LPN care. Hypoxia (A), anemia (B), and JVD/hypotension (C) require RN assessment.
What is the significance of a positive tuberculin skin test?
- A. The client has an active infection.
- B. Antibodies are present in the client's blood.
- C. The client is immune to this type of disease.
- D. The client needs to be in strict isolation.
Correct Answer: B
Rationale: A positive tuberculin skin test indicates the presence of antibodies to tuberculosis, suggesting exposure or latent infection, not necessarily active disease.
The nurse provides directions to the client on the proper use of a peak flow meter. Arrange the steps for the nurse's instruction to the client on the proper use of a peak flow meter in the correct sequence.
- A. Slide the marker to zero.
- B. Take a deep breath.
- C. Put the mouthpiece of the flow meter into your mouth.
- D. Blow out as fast as you can.
- E. Empty all of the air from your lungs.
- F. Record the highest rating after the current sequence.
Correct Answer: A, B, C, D, E, F
Rationale: The correct sequence is: 1. Slide the marker to zero, 2. Take a deep breath, 3. Put the mouthpiece in your mouth, 4. Blow out as fast as you can, 5. Empty all of the air from your lungs, 6. Record the highest rating.
You're assisting your patient who has asthma to bed. The patient is experiencing a frequent cough and chest tightness. You auscultate the patient's lung fields and note expiratory wheezes. The patient's peak flow rate is 78% less than their best peak flow reading. Which medication will provide the patient with the fastest relief from these signs and symptoms of an asthma attack?
- A. Theophylline
- B. Tiotropium
- C. Albuterol
- D. Cromolyn
Correct Answer: C
Rationale: Albuterol is a short-acting beta-agonist that provides rapid bronchodilation, making it the fastest-acting medication for acute asthma symptoms.