Extract:

Question 1 of 5

A nurse in the med-surgical ICU is evaluating a patient with a diagnosis of chronic copd. The patient is receiving oxygen at a flow rate of 10 L/min via facemask. Which finding would concern the nurse to act immediately?

A. Respiratory rate of 8 bpmB. A large barrel chestC. Fine cracklesD. The patient assumes the orthopenic position

Correct Answer: A

Rationale: A respiratory rate of 8 bpm indicates respiratory depression, potentially due to high-flow oxygen suppressing the respiratory drive in COPD patients, requiring immediate intervention.

Question 2 of 5

A nurse is caring for a client who has Parkinson's disease and is taking diphenhydramine 25 mg PO TID. Which of the following therapeutic outcomes should the nurse expect to see?

A. Improved bladder functionB. Relief of depressionC. Decreased tremorsD. Delay in disease progression

Correct Answer: C

Rationale: Diphenhydramine's anticholinergic properties reduce tremors in Parkinson's by balancing dopamine and acetylcholine levels.

Question 3 of 5

A nurse in the respiratory unit is caring for client who has a past medical history of heart failure and is currently admitted for asthma exacerbation. When reviewing the provider's orders further clarification is needed for which of the following medications?

A. PrednisoneB. MetropololC. LabetololD. Albuterol

Correct Answer: B

Rationale: Metoprolol, a beta-blocker, can exacerbate bronchospasm in asthma patients by blocking beta-2 receptors in the lungs, requiring clarification due to the client's asthma.

Question 4 of 5

The nurse is educating a patient who is newly diagnosed with amyotrophic lateral sclerosis (ALS). Which statement would be the most appropriate for the nurse to include in education?

A. ALS is caused by excess chemicals in the brain. The symptoms can be controlled with medication.'B. The disease is progressive and will eventually lead to paralysis while maintaining cognitive function.'C. Before you lose cognitive function, you should consider creating an advanced directive.'D. Despite severe symptoms right now, most patients recover with treatment.'

Correct Answer: B

Rationale: ALS is progressive, leading to paralysis while typically preserving cognitive function, making this the most accurate educational statement.

Question 5 of 5

A nurse instructs a 60-year-old client diagnosed with asthma about using a peak expiratory flow meter. Which immediate action should the nurse recommend to the client that obtains a reading of 82% on their peak flow meter?

A. Go to the emergency departmentB. Continue to use salmeterol and fluticasone as prescribedC. Administer an additional rescue dose of AlbuterolD. Call the physician

Correct Answer: C

Rationale: The correct immediate action is to administer a rescue dose of albuterol. Albuterol is a short-acting beta-agonist that helps open the airways quickly during an asthma exacerbation. A PEFR of 82% falls in the yellow zone, suggesting some obstruction but not an emergency situation.