The nurse discusses management of upper respiratory infections (URIs) with a patient who has acute sinusitis. Which statement by the patient indicates that additional teaching is needed?

Correct Answer: B

Rationale: The correct answer is B because using nasal decongestant spray for an extended period can lead to rebound congestion and worsening of symptoms. Choice A is correct as hydration helps thin mucus. Choice C is correct as acetaminophen can help alleviate sinus discomfort. Choice D is correct as changes in nasal secretions or sputum can indicate worsening infection.

Correct Answer: A

Rationale: The correct answer is A: Chest Pain. Chest pain is not typically an initial sign or symptom of tuberculosis. The most common initial signs and symptoms include fatigue, morning cough, and lethargy. Monitoring for these symptoms is crucial in detecting tuberculosis early for prompt treatment. Chest pain may occur in later stages or due to complications but is not a primary indicator. Thus, the nurse should focus on observing for fatigue, morning cough, and lethargy as initial signs of tuberculosis in individuals at the homeless shelter.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Pruritus, cutaneous flushing. Niacin, also known as nicotinic acid, is commonly prescribed to help lower lipid levels. The adverse effects of pruritus (itching) and cutaneous flushing (reddening of the skin) are well-documented with niacin therapy. These effects are due to prostaglandin-mediated vasodilation and are often referred to as "niacin flush." While uncomfortable, they are usually harmless and can be minimized by taking the medication with food or using a slow-release formulation. Option B) Tinnitus, urine with a burnt odor, is incorrect because these are not commonly associated adverse effects of niacin. Tinnitus is more commonly associated with medications that affect the auditory system, while urine with a burnt odor is not a typical side effect of niacin. Option C) Myalgia, fatigue, and Option D) Blurred vision, headaches are also incorrect. Myalgia and fatigue are more commonly associated with statin therapy rather than niacin. Blurred vision and headaches are not typically seen as adverse effects of niacin therapy. Educationally, understanding the common adverse effects of medications is crucial for nurses to provide safe and effective care. By knowing the expected side effects of niacin, nurses can educate patients on what to expect, how to manage these effects, and when to seek further medical advice. This knowledge enhances patient safety and promotes medication adherence.

Correct Answer: C

Rationale: In this scenario, the correct nursing intervention for a patient experiencing pain due to acute pericarditis is to place the patient in Fowler's position, leaning forward on the table (Option C). This position helps reduce the pressure on the inflamed pericardium, thereby decreasing the pain experienced by the patient. Option A, teaching the patient to take deep, slow breaths, is a common intervention for many types of pain but may not specifically address the underlying cause of pericarditis. Option B, forcing fluids to 3000 mL/day, is not directly related to managing pain in pericarditis but rather focuses on hydration and inflammation reduction through increased fluid intake. Option D, providing an ice bag every hour, is not recommended for pericarditis as cold applications can exacerbate inflammation in this condition. Educationally, it is important for nursing students to understand the rationale behind different interventions to effectively manage patient care. By knowing the pathophysiology of pericarditis and how different interventions impact the condition, nurses can provide safe and effective care to patients experiencing this condition. Understanding the reasoning behind each option helps to enhance critical thinking skills and clinical decision-making abilities in nursing practice.

Correct Answer: A

Rationale: In this scenario, the correct action for the nurse to take is option A) Document the accurate functioning of the tube. This is the correct choice because fluctuations in the water seal chamber indicate that the chest tube is functioning properly, allowing for the equalization of pressure within the pleural space. Documenting this observation is crucial for monitoring the patient's condition and treatment effectiveness. Option B) Notify the physician immediately is incorrect in this situation because fluctuations in the water seal chamber are an expected and normal finding after chest tube insertion, indicating proper functioning. There is no need for immediate notification unless there are other concerning signs or symptoms present. Option C) Clamping the chest tube would be detrimental as it would obstruct the drainage system, potentially leading to a tension pneumothorax or other complications. Option D) Increasing the suction pressure is also incorrect as it can cause excessive drainage, leading to complications such as tissue damage or increased risk of infection. Educationally, understanding the purpose and function of a chest tube and its components is crucial for nurses caring for patients requiring this intervention. Monitoring and interpreting the water seal chamber's fluctuations are essential skills to ensure the chest tube's effectiveness and the patient's safety. Documenting observations accurately is a fundamental aspect of nursing practice, providing a record for continuity of care and communication among healthcare team members.