When caring for a patient with emphysema, the nurse would include which of the following diagnoses as priority in the plan of care?
A) Ineffective coping
B) Self-care deficit
C) Activity intolerance
D) Impaired gas exchange
Ans: D
Feedback: Impaired gas exchange related to ventilation-perfusion inequality would be the priority nursing diagnosis for a patient with emphysema. The other listed nursing diagnoses are important in the care of a patient with emphysema but would not be the priority for this patient.
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It is estimated that BSE is only performed on a routine basis by 25% to 30% of women. What is one reason women do not perform BSE monthly?
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A client with cancer of the rectum is scheduled for surgery and the placement of a permanent ostomy. The nurse includes discussion of which of the following types of ostomies in the client's presurgical education plan?
1. Sigmoid 2. Duodenal 3. Double-barrel 4. Transverse loop
The health care provider is considering the use of sumatriptan (Imitrex) for a 54-year-old male patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider?
a. The patient drinks 1 to 2 cups of coffee daily. b. The patient had a recent acute myocardial infarction. c. The patient has had migraine headaches for 30 years. d. The patient has taken topiramate (Topamax) for 2 months.
Which question would provide the nurse would the best information when assessing an elderly client who presents to the emergency department complaining of dyspnea and shortness of breath?
A) "How does your difficulty breathing affect your daily function?" B) "When did you have your last chest x-ray?" C) "Have you had the influenza immunization this year?" D) "Have you ever been exposed to tuberculosis?"