Nokea
You're educating a patient how to use a peak flow meter to help monitor the status of their asthma. Which statement by the patient demonstrates they understand how to use the device?
- A. This device will help keep my lungs strong so I don't have another asthma attack.
- B. I will inhale as hard as I can while using the device.
- C. I will use this device at the same time, either in the morning or before bedtime, and compare the readings with my personal best reading.
- D. I will notify the doctor if my peak flow rating is 90% or more than my personal best peak flow.
Correct Answer: C
Rationale: Correct use involves measuring peak flow at consistent times and comparing to personal best to monitor asthma control. Inhaling is incorrect, and a high reading is not a concern.
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Which nursing action is most appropriate immediately after the chest tube is removed from the client?
- A. Apply a sterile dressing and tape it securely.
- B. Request a chest X-ray to assess lung fields.
- C. Administer oxygen by nasal cannula.
- D. Encourage the client to cough vigorously.
Correct Answer: A
Rationale: Applying a sterile dressing taped securely prevents air entry into the pleural space and promotes healing post-chest tube removal.
A client comes to the clinic with a bloody nose. Which instruction is most appropriate?
- A. Sit up with your head tilted forward. Grasp the soft part of your nose firmly between your thumb and forefinger.'
- B. Lay down and tilt your head backward. Grasp the end of your nose between your fingers.'
- C. Sit up and lean backwards. Put pressure on the side of your nose with your hand.'
- D. Lie down with your head lower than your feet. Grasp as much of your nose as possible between your fingers.'
Correct Answer: A
Rationale: Sitting with the head tilted forward and grasping the soft part of the nose prevents aspiration of blood and effectively stops bleeding.
A 72 year-old male patient who is diagnosed with bilateral lower lobe pneumonia is admitted to your unit. The patient has a history of systolic heart failure and arthritis. On assessment, you note the patient has a respiratory rate of 21 , oxygen saturation $93 \%$ on $2 \mathrm{~L}$ nasal cannula, is alert & oriented, and has a productive cough with green/yellowish sputum. Which of the following nursing interventions will you provide to this patient based on your assessment findings and the patient's diagnosis? Select-all-that-apply:
- A. Keep head-of-the-bed less than 30 degrees at all times.
- B. Collect sputum cultures.
- C. Encourage 3L of fluids a day to keep secretions thin.
- D. Encourage incentive spirometer usage
- E. Provide education about receiving the Pneumovax vaccine annually.
Correct Answer: B,D
Rationale: Sputum cultures identify the causative organism, and incentive spirometer use promotes lung expansion. Head-of-bed <30 degrees increases aspiration risk, 3L fluids may overload heart failure patients, and Pneumovax is not annual.
When performing the client's tracheostomy care, which nursing action is correct?
- A. Cut a gauze square to fit around the client's stoma.
- B. Secure the ties at the back of the client's neck.
- C. Attach new ties before removing old ones.
- D. Replace the cannula after changing the ties.
Correct Answer: C
Rationale: Attaching new ties before removing old ones ensures the tracheostomy tube remains secure, preventing accidental dislodgement.
Which is the correct volume needed for the nurse to administer the prescribed dose of 0.1 mg of epinephrine to the client?
- A. 0.001 mL
- B. 0.1 mL
- C. 1.0 mL
- D. 10 mL
Correct Answer: B
Rationale: For a 1:1,000 epinephrine solution (1 mg/mL), a 0.1 mg dose equals 0.1 mL, calculated as 0.1 mg ÷ 1 mg/mL = 0.1 mL.