Nursing 1250 Exam 1 Practice

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Questions and Answers

A patient with pneumonia is experiencing dyspnea and a productive cough. What is the most appropriate initial nursing intervention?

  • Position the patient in high Fowler's position. (correct)
  • Initiate oxygen therapy at 6L/min.
  • Administer prescribed antibiotics.
  • Perform postural drainage.

Which of the following is a hallmark sign of community-acquired pneumonia?

  • Hemoptysis
  • Persistent dry cough
  • Night sweats
  • Acute onset of fever and chills (correct)

What is a priority diagnostic test for pneumonia?

  • Sputum culture
  • ABG analysis
  • Chest X-ray (correct)
  • Pulmonary function test

Which intervention is most appropriate to prevent hospital-acquired pneumonia?

<p>Encourage hourly use of an incentive spirometer. (B)</p> Signup and view all the answers

What is a common early sign of sepsis in a patient with pneumonia?

<p>Fever (C)</p> Signup and view all the answers

The nurse understands that a patient with pneumonia may have which abnormal laboratory finding?

<p>Increased WBC count (D)</p> Signup and view all the answers

A patient with pneumonia reports worsening symptoms despite antibiotic therapy. What should the nurse assess first?

<p>Compliance with medication (C)</p> Signup and view all the answers

What is the primary mode of transmission for tuberculosis (TB)?

<p>Inhalation of airborne droplets (C)</p> Signup and view all the answers

A patient with a positive TB skin test (PPD) asks what this means. What is the best response?

<p>Further tests are needed to determine if you have active or latent TB. (C)</p> Signup and view all the answers

Which medication is commonly prescribed for latent TB?

<p>Isoniazid (B)</p> Signup and view all the answers

What type of isolation precautions should be implemented for a patient with suspected TB?

<p>Airborne precautions (B)</p> Signup and view all the answers

A nurse is caring for a patient taking rifampin. What side effect should the patient be informed about?

<p>Red-orange discoloration of body fluids (A)</p> Signup and view all the answers

What is the purpose of the BCG vaccine?

<p>Provide immunity against TB. (C)</p> Signup and view all the answers

Which diagnostic tool is most effective for diagnosing obstructive sleep apnea?

<p>Polysomnography (sleep study) (B)</p> Signup and view all the answers

What lifestyle change can reduce the risk of obstructive sleep apnea?

<p>Maintaining a healthy weight (A)</p> Signup and view all the answers

A patient with sleep apnea is prescribed a CPAP machine. What is the primary purpose of this device?

<p>Prevent upper airway collapse during sleep. (B)</p> Signup and view all the answers

What is a classic symptom of obstructive sleep apnea?

<p>Morning headaches (D)</p> Signup and view all the answers

Which patient is at highest risk for obstructive sleep apnea?

<p>A 40-year-old obese male smoker (A)</p> Signup and view all the answers

Which symptom is most commonly associated with a pneumothorax?

<p>Sudden onset of chest pain and dyspnea (A)</p> Signup and view all the answers

What is the priority nursing action when caring for a patient with a chest tube?

<p>Ensure the drainage system is upright and below chest level. (B)</p> Signup and view all the answers

During chest tube care, the nurse notices continuous bubbling in the water seal chamber. What does this indicate?

<p>An air leak in the system (A)</p> Signup and view all the answers

What is the primary purpose of thoracentesis?

<p>Obtain a sample of pleural fluid for analysis. (D)</p> Signup and view all the answers

A patient with a pleural effusion is scheduled for a thoracentesis. What is the nurse's priority action during the procedure?

<p>Monitor for signs of pneumothorax. (B)</p> Signup and view all the answers

A patient has a hemothorax. What clinical manifestation should the nurse expect?

<p>Decreased lung sounds on the affected side (D)</p> Signup and view all the answers

What intervention is necessary to maintain a closed chest tube drainage system?

<p>Secure all connections to prevent air leaks. (D)</p> Signup and view all the answers

What is the primary risk factor for COPD?

<p>Smoking tobacco (D)</p> Signup and view all the answers

Which clinical manifestation is most consistent with COPD?

<p>Chronic productive cough and wheezing (B)</p> Signup and view all the answers

What is a priority intervention for a patient with acute COPD exacerbation?

<p>Position the patient in tripod position. (C)</p> Signup and view all the answers

The nurse understands that COPD pathophysiology includes which finding?

<p>Bronchoconstriction and increased airway resistance (C)</p> Signup and view all the answers

Which lab value is most important to monitor in a patient with COPD?

<p>Arterial blood gases (ABGs) (B)</p> Signup and view all the answers

What is a common complication of long-term COPD?

<p>Cor pulmonale (D)</p> Signup and view all the answers

What does the "P" in the PICOT framework represent?

<p>Population (D)</p> Signup and view all the answers

Which type of research evidence is considered the strongest?

<p>Randomized controlled trial (B)</p> Signup and view all the answers

How is reliability defined in research?

<p>The ability to replicate study findings consistently (B)</p> Signup and view all the answers

A nurse reads a research study about a new intervention. What is the next step in the EBP process?

<p>Critically appraise the study's validity and relevance. (B)</p> Signup and view all the answers

Which lab value is most concerning in a patient with respiratory acidosis?

<p>pH 7.30 (C)</p> Signup and view all the answers

What is the normal range for PaO2 in arterial blood gases?

<p>80-100 mmHg (A)</p> Signup and view all the answers

Which lab value would be expected in a patient with an acute bacterial infection?

<p>Elevated WBC count (A)</p> Signup and view all the answers

What is the priority nursing intervention for a patient with a potassium level of 2.9 mEq/L?

<p>Administer potassium chloride as prescribed. (D)</p> Signup and view all the answers

Which lab value is critical to monitor in a patient receiving anticoagulant therapy?

<p>PT/INR (B)</p> Signup and view all the answers

Flashcards

High Fowler's Position for Pneumonia

A position where the head of the bed is raised to 60-90 degrees; promotes lung expansion and reduces dyspnea.

Hallmark sign of Community-Acquired Pneumonia

Sudden onset of fever, chills, and a productive cough, typically indicating an infection.

Chest X-ray for Pneumonia

A medical imaging test used to visualize the lungs and confirm the presence and location of pneumonia.

Incentive Spirometer for Hospital-Acquired Pneumonia

A device used to promote lung expansion and prevent atelectasis, reducing the risk of hospital-acquired pneumonia.

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Early sign of Sepsis in Pneumonia

Fever is a common early sign of systemic infection, potentially indicating sepsis in patients with pneumonia.

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Changes in WBC Count in Pneumonia

An elevated WBC count indicates an inflammatory or infectious process, like pneumonia, as the body fights infection.

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Noncompliance with Antibiotics in Pneumonia

Noncompliance with medication can lead to ineffective treatment and worsening symptoms, so it's crucial to ensure the patient is taking the antibiotics as prescribed.

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Transmission of Tuberculosis

The primary mode of transmission for TB is through inhalation of airborne droplets when an infected person coughs or sneezes.

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Positive TB Skin Test

A positive PPD test indicates exposure to TB bacteria, but further testing is needed to determine if the infection is active or latent.

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Isoniazid for Latent TB

A medication commonly prescribed for latent TB to prevent progression to active disease.

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Isolation Precautions for Suspected TB

Airborne precautions are used to prevent the spread of TB via respiratory droplets.

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Side Effect of Rifampin

A common side effect of rifampin, causing red-orange discoloration of body fluids like urine and tears.

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Purpose of BCG Vaccine

The Bacille Calmette-Guérin (BCG) vaccine offers some protection against TB, particularly in high-prevalence areas.

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Diagnosis of Obstructive Sleep Apnea

A polysomnography (sleep study) is the most effective diagnostic tool for evaluating sleep patterns, oxygen levels, and breathing interruptions, which are characteristic of obstructive sleep apnea.

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Lifestyle Change for Obstructive Sleep Apnea

Maintaining a healthy weight can reduce the risk of obstructive sleep apnea by reducing airway obstruction.

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CPAP Machine for Obstructive Sleep Apnea

A CPAP machine maintains positive airway pressure during sleep to prevent airway collapse, a common cause of obstructive sleep apnea.

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Classic Symptom of Obstructive Sleep Apnea

Morning headaches are a common symptom of obstructive sleep apnea, resulting from nocturnal hypoxia and poor sleep quality.

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Risk Factors for Obstructive Sleep Apnea

Obesity, smoking, and being male are significant risk factors that increase the likelihood of developing obstructive sleep apnea.

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Symptoms of Pneumothorax

A sudden onset of chest pain and dyspnea due to air entering the pleural space and collapsing the lung.

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Chest Tube Care: Drainage System Positioning

The chest drainage system must be kept upright and below the chest to prevent backflow and ensure effective drainage.

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Chest Tube Care: Water Seal Bubbling

Continuous bubbling in the water seal chamber indicates an air leak in the chest tube system, which needs immediate attention.

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Purpose of Thoracentesis

A procedure used to remove a sample of pleural fluid for diagnostic or therapeutic purposes.

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Nursing Care during Thoracentesis

Pneumothorax is a potential complication of thoracentesis as lung injury can occur during the procedure, so it is crucial to closely monitor for signs of collapsed lung.

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Clinical Manifestation of Hemothorax

Hemothorax causes blood to accumulate in the pleural space, leading to diminished lung sounds on the affected side.

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Closed Chest Tube Drainage System Maintenance

Secure connections are crucial for maintaining a closed chest tube drainage system to prevent accidental air leaks and ensure effective drainage.

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Primary Risk Factor for COPD

Smoking is the leading risk factor for COPD, significantly contributing to airway and alveolar damage.

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Clinical Manifestation of COPD

Chronic productive cough, wheezing, and dyspnea (shortness of breath) are common signs of COPD

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Intervention for Acute COPD Exacerbation

The tripod position supports lung expansion and reduces dyspnea in COPD patients during acute exacerbations.

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Pathophysiology of COPD

COPD involves bronchoconstriction, inflammation, and airway obstruction due to mucus buildup, making it hard to breathe.

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Important Lab Value for COPD

Arterial blood gases (ABGs) provide critical information about oxygenation and CO2 retention in COPD patients, guiding treatment decisions.

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Common Complication of Long-Term COPD

Cor pulmonale, a type of right-sided heart failure, is a common complication of long-term COPD, caused by increased pulmonary vascular resistance.

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P in PICOT Framework

The "P" in PICOT represents Population, the specific group of individuals being studied in a research question.

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Strongest type of Research Evidence

Randomized controlled trials (RCTs) are considered the strongest type of research evidence, providing the most reliable and unbiased results.

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Reliability in Research

Reliability in research refers to the consistency and repeatability of study findings, ensuring the results are dependable.

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Next Step in EBP After Reading Research

After reading a research study about a new intervention, the next step in the EBP process is to critically appraise the study's validity and relevance to ensure it is sound and applicable to practice.

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Study Notes

Exam 1 Practice

  • Question 1: A patient with pneumonia and dyspnea, requires positioning in high Fowler's position for lung expansion.

  • Question 2: A hallmark sign of community-acquired pneumonia is an acute onset of fever and chills.

  • Question 3: A priority diagnostic test for pneumonia is a chest X-ray.

  • Question 4: To prevent hospital-acquired pneumonia, encourage hourly use of an incentive spirometer to promote lung expansion.

Question 5

  • Early sign of sepsis in a patient with pneumonia is fever.

Question 6

  • An abnormal lab finding in a patient with pneumonia is an increased white blood cell (WBC) count.

Question 7

  • A priority nursing assessment for a patient with worsening symptoms despite antibiotic therapy is medication compliance.

Section 2: Tuberculosis

  • Question 8: The primary mode of transmission for tuberculosis (TB) is through the inhalation of airborne droplets.

Section 3: Obstructive Sleep Apnea

  • Question 14: A polysomnography is the most effective tool for diagnosing obstructive sleep apnea.

  • Question 15: Maintaining a healthy weight can reduce risk of obstructive sleep apnea.

  • Question 16: The primary purpose of a CPAP machine is to prevent upper airway collapse during sleep.

Question 17

  • A classic symptom of obstructive sleep apnea is morning headaches.

Question 18

  • A 40-year-old obese male smoker is at highest risk for obstructive sleep apnea.

Section 4: Pleural Disorders and Chest Tubes

  • Question 19: A pneumothorax is associated with sudden onset of chest pain and dyspnea.

  • Question 20: A priority nursing action for a patient with a chest tube is to ensure the drainage system is upright and below chest level to prevent backflow.

Question 21

  • Continuous bubbling in the water-seal chamber of a chest tube indicates an air leak in the system.

Question 22

  • Thoracentesis is primarily used to obtain a sample of pleural fluid for analysis.

Question 23

  • During a thoracentesis, a priority action for nurses is to monitor for signs of pneumothorax.

Question 24

  • A patient with hemothorax should display decreased lung sounds on the affected side.

Section 5: Chronic Obstructive Pulmonary Disease (COPD)

  • Question 26: Smoking tobacco is a major risk factor for COPD

  • Question 27: Chronic productive cough and wheezing is a clinical manifestation consistent with COPD.

  • Question 28: A priority intervention for acute COPD exacerbation is positioning the patient in a tripod position.

Question 29

  • COPD pathophysiology includes bronchoconstriction and increased airway resistance.

Question 30

  • The most important lab value to monitor in a COPD patient is arterial blood gases (ABGs).

Question 31

  • A complication of long-term COPD is cor pulmonale (right-sided heart failure).

Section 6: Evidence-Based Practice (EBP)

  • Question 32: The "P" in the PICOT framework represents the population being studied.

Question 33

  • Randomized controlled trials (RCTs) are the strongest type of research evidence.

Question 34

  • Reliability in research refers to the consistency and repeatability of study findings.

Question 35

  • Critically appraising the study's validity and relevance is the next step after reading a research study in the EBP process.

Section 7: Lab Values

  • Question 36: A pH of 7.30 is a concerning lab value in a patient with respiratory acidosis.

Question 37

  • The normal range for PaO2 in arterial blood gases is 80-100 mmHg.

Question 38

  • A patient with an acute bacterial infection is expected to have an elevated WBC count.

Question 39

  • A potassium level of 2.9 mEq/L requires the administration of potassium chloride as prescribed.

Question 40

  • PT/INR levels are critical to monitor in a patient receiving anticoagulant therapy.

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