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 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.
A patient, who is receiving continuous IV Heparin for the treatment of a DVT, has an aPTT of 110 seconds. What is your next nursing action per protocol?
- A. Continue with the infusion because no change is needed based on this aPTT.
- B. Increase the drip rate per protocol because the aPTT is too low.
- C. Re-draw the aPTT STAT.
- D. Hold the infusion for 1 hour and decrease the rate per protocol because the aPTT is too high.
Correct Answer: D
Rationale: The aPTT is 110 seconds, which is too high. Any aPTT value greater than 80 seconds places the patient at risk for bleeding. Most Heparin protocols dictate that the nurse would hold the infusion for 1 hour and to decrease the rate of infusion. If the aPTT is less than 60 seconds, the dose would need to be increased and a bolus may be needed. aPTT values should be around 60-80 seconds to achieve a therapeutic response for Heparin.
The nurse is caring for a client with a right-sided chest tube secondary to a pneumothorax. Which interventions should the nurse implement when caring for this client? Select all that apply.
- A. Place the client in the low Fowler's position.
- B. Assess chest tube drainage system frequently.
- C. Maintain strict bedrest for the client.
- D. Secure a loop of drainage tubing to the sheet.
- E. Observe the site for subcutaneous emphysema.
Correct Answer: B
Rationale: Frequent system checks (B), securing tubing (D), and monitoring emphysema (E) ensure chest tube function. Low Fowler’s (A) is incorrect (semi-Fowler’s preferred), and bedrest (C) is unnecessary.
The nurse is preparing the client for a polysomnography to confirm sleep apnea. Which preprocedure instruction should the nurse include?
- A. The client should not eat or drink past midnight.
- B. The client will receive a sedative for relaxation.
- C. The client will sleep in a laboratory for evaluation.
- D. The client will wear a monitor at home for this test.
Correct Answer: C
Rationale: Polysomnography involves overnight monitoring in a sleep lab (C) to assess sleep patterns and confirm sleep apnea. Fasting (A) is unnecessary. Sedatives (B) are avoided to ensure natural sleep. Home monitors (D) are used for different tests, not polysomnography.
Based on Virchow's Triad, select which patients below are at RISK for the development of a deep vein thrombosis? Select all that apply:
- A. A 55-year-old male with hyperlipidemia and diabetes.
- B. A 70-year-old female with severe sepsis.
- C. A 25-year-old male who uses intravenous drugs.
- D. A 65-year-old female who is post-op day 1 after joint replacement surgery.
Correct Answer: B,C,D
Rationale: Virchow's Triad details the THREE factors for blood clot formation within the vessel. Remember 'SHE': Stasis of Venous Blood, Hypercoagulability (means excessive coagulability), Endothelial damage. Patients who experience sepsis are at risk for hypercoagulability of the blood. Patients who use IV drugs damage the endothelial lining of the veins and this can lead to blood clot formation. Patients who've had joint replacement surgery are at risk for blood clots due to stasis of venous circulation etc.