Nokea
You are providing teaching to a patient with chronic COPD on how to perform diaphragmatic breathing. This technique helps do the following:
- A. Increase the breathing rate to prevent hypoxemia
- B. Decrease the use of the abdominal muscles
- C. Encourages the use of accessory muscles to help with breathing
- D. Strengthen the diaphragm
Correct Answer: D
Rationale: Diaphragmatic breathing strengthens the diaphragm , improving breathing efficiency in COPD. It doesn't increase breathing rate , decrease abdominal muscle use , or encourage accessory muscle use .
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The wife of a client with active tuberculosis has a positive skin test for tuberculosis. She is to be started on prophylactic drug therapy. What drug is the drug of choice for prophylaxis of tuberculosis?
- A. Streptomycin
- B. Para-aminosalicylic (PAS) acid
- C. Isoniazid (INH)
- D. Ethambutol (Myambutol)
Correct Answer: C
Rationale: Isoniazid is the drug of choice for tuberculosis prophylaxis due to its effectiveness in preventing active disease.
Which data are significant when assessing a client diagnosed with rule-out Legionnaires' disease?
- A. The amount of cigarettes smoked a day and the age when started.
- B. Symptoms of aching muscles, high fever, malaise, and coughing.
- C. Exposure to a saprophytic water bacterium transmitted into the air.
- D. Decreased bilateral lung sounds in the lower lobes.
Correct Answer: B
Rationale: Symptoms like aching muscles, high fever, malaise, and coughing (B) are characteristic of Legionnaires' disease, a severe pneumonia. Smoking history (A) is non-specific. Exposure to Legionella (C) is a risk factor, not a clinical datum. Decreased lung sounds (D) are less specific than systemic symptoms.
Which statement indicates the client diagnosed with asthma needs more teaching concerning the medication regimen?
- A. I will take Singulair, a leukotriene, every day to prevent allergic asthma attacks.
- B. I need to use my Intal, cromolyn inhaler, 15 minutes before I begin my exercise.
- C. I need to take oral glucocorticoids every day to prevent my asthma attacks.
- D. If I have an asthma attack, I need to use my albuterol, a beta2 agonist, inhaler.
Correct Answer: C
Rationale: Daily oral glucocorticoids (C) are not typically used for asthma maintenance due to significant side effects; they are reserved for severe exacerbations or specific cases. Inhaled corticosteroids or leukotriene modifiers (like Singulair, A) are preferred for long-term control. Using cromolyn before exercise (B) is correct to prevent exercise-induced bronchospasm. Albuterol for acute attacks (D) is appropriate as a rescue inhaler.
Which clinical manifestation would the nurse assess in the client newly diagnosed with intrinsic lung cancer?
- A. Dysphagia.
- B. Foul-smelling breath.
- C. Hoarseness.
- D. Weight loss.
Correct Answer: C
Rationale: Hoarseness (C) is a common early symptom of intrinsic lung cancer due to tumor compression of the recurrent laryngeal nerve. Dysphagia (A) is more typical of esophageal involvement. Foul-smelling breath (B) is non-specific. Weight loss (D) occurs later in advanced disease.
The physician orders the patient to start taking Omalizumab. How will you administer this medication as the nurse?
- A. Intravenous
- B. Intramuscular
- C. Orally
- D. Subcutaneously
Correct Answer: D
Rationale: Omalizumab is administered subcutaneously for asthma treatment.