BOOKLE T CODE: 0: 4. A 42-year-old woman came to hospital with malaise and cough for four days.Her cough has mucopurul ent sputum but dry and irritating in the beginning . On assessmer t she has inspiratory wheezing;moist inspiratory crackle s, temperature 38.8^circ c respiratory rate 24/min, pulse 96/min and blood pressure 100/?o mmHg. What is the priority nursing diagnosis for this patient? (C) Impaired breathing pattern (A) Acute Pain (D) Ineffective air way clearance (B)Hyperthermia 5. A 35-year -old woman admitted in medical ward with diagnosis of heart failure.On assessment the patient has fatigue drowsiness and delayed reaction time Her blood pressure is 100/60 Respiratory rate 32/min and pulse rate 110/min.The nurse in charge in the ward decided to give oxygen. What is the most likely reason for the nurse decision to give oxygen? (A) Pulse rate (C)Respiratory rate (B) Drowsiness (D)reaction time 6. A 57-year-old known RVI patient admitted in medical ward The patient has Cough with mucopurulent sputum dyspnea,orthopinia.headache and cracklcs.On assessmen the nurse found Chest pain with deep breathing and also has cyanotic lip Vital sign: Tcmperature=39^circ C C. Respirator rate 30 min.Pulse rate=104/min and Blood pressure 11076mmHg What is the priority nursing intervention in the above case? (A) Administer oxygen (C) Administer acetaminophen (B) Administer oral fluids (D) Administer expectorants as ordered 7. A 57-year-ol known Diabetic intubated man admitted in intensive care unit for four days. He has developed chest pain that intensified by breathing.He has Cough,Dyspnea and crackles. His body Temperature 38.9^circ C WBC 15000 cell/ml and has newly developed parenchymal opacity on chest radiography. What is the most likely diagnosis for this patient? (A) Hospital acquire pneumonia (B).Communit y acquired pneumonia (C) Ventilator associated pneumonia (D) Health care associated pncumonia 8. A 32-year-old female patient presented with complaints of itching and burning sensation of face and hands for one day She said, it happens following one day of washing her face and hand with new brand soap.She has weeping and formed crusts skin lcsions on face and hands.She feels that her skin was peeling. What type of hypersensitiv ity does the patient have? (A) Type I (B) Type II (C) Type III (D) Type IV MOH/HPLE -Nursing 2012/2020 Generated by CamScanr her BOO KLET CO DE: 011 9. A 42 -year-old male patient presented to hospital with compliant of weakness,fatigue and dizziness for 20 days. His BMI is 28kg/m^2 and hemoglobin 10 mg/dl. What is the most likely ART drug related to this side effect? (A) Tenofovir (C)Zidovudine (B) Efavirenz (D)Lamivudine fter counseling, 3 2 SUBJECT CODE: 01 SUBJECT CODE: 01

Question

BOOKLE T CODE: 0: 4. A 42-year-old woman came to hospital with malaise and cough for four days.Her cough has mucopurul ent sputum but dry and irritating in the beginning . On assessmer t she has inspiratory wheezing;moist inspiratory crackle s, temperature 38.8^circ c respiratory rate 24/min, pulse 96/min and blood pressure 100/?o mmHg. What is the priority nursing diagnosis for this patient? (C) Impaired breathing pattern (A) Acute Pain (D) Ineffective air way clearance (B)Hyperthermia 5. A 35-year -old woman admitted in medical ward with diagnosis of heart failure.On assessment the patient has fatigue drowsiness and delayed reaction time Her blood pressure is 100/60 Respiratory rate 32/min and pulse rate 110/min.The nurse in charge in the ward decided to give oxygen. What is the most likely reason for the nurse decision to give oxygen? (A) Pulse rate (C)Respiratory rate (B) Drowsiness (D)reaction time 6. A 57-year-old known RVI patient admitted in medical ward The patient has Cough with mucopurulent sputum dyspnea,orthopinia.headache and cracklcs.On assessmen the nurse found Chest pain with deep breathing and also has cyanotic lip Vital sign: Tcmperature=39^circ C C. Respirator rate 30 min.Pulse rate=104/min and Blood pressure 11076mmHg What is the priority nursing intervention in the above case? (A) Administer oxygen (C) Administer acetaminophen (B) Administer oral fluids (D) Administer expectorants as ordered 7. A 57-year-ol known Diabetic intubated man admitted in intensive care unit for four days. He has developed chest pain that intensified by breathing.He has Cough,Dyspnea and crackles. His body Temperature 38.9^circ C WBC 15000 cell/ml and has newly developed parenchymal opacity on chest radiography. What is the most likely diagnosis for this patient? (A) Hospital acquire pneumonia (B).Communit y acquired pneumonia (C) Ventilator associated pneumonia (D) Health care associated pncumonia 8. A 32-year-old female patient presented with complaints of itching and burning sensation of face and hands for one day She said, it happens following one day of washing her face and hand with new brand soap.She has weeping and formed crusts skin lcsions on face and hands.She feels that her skin was peeling. What type of hypersensitiv ity does the patient have? (A) Type I (B) Type II (C) Type III (D) Type IV MOH/HPLE -Nursing 2012/2020 Generated by CamScanr her BOO KLET CO DE: 011 9. A 42 -year-old male patient presented to hospital with compliant of weakness,fatigue and dizziness for 20 days. His BMI is 28kg/m^2 and hemoglobin 10 mg/dl. What is the most likely ART drug related to this side effect? (A) Tenofovir (C)Zidovudine (B) Efavirenz (D)Lamivudine fter counseling, 3 2 SUBJECT CODE: 01 SUBJECT CODE: 01

Answer 1

4. The priority nursing diagnosis for this patient is (D) Ineffective airway clearance. The patient's symptoms of cough with mucopurulent sputum, inspiratory wheezing, moist inspiratory crackles, and elevated respiratory rate indicate that there is an obstruction in the airway that needs to be cleared.5. The most likely reason for the nurse's decision to give oxygen to this patient is (C) Respiratory rate. The patient's respiratory rate of 32/min is elevated, which may indicate that the patient is not getting enough oxygen. Administering oxygen can help to increase the oxygen levels in the blood and improve the patient's respiratory function.6. The priority nursing intervention for this patient is (A) Administer oxygen. The patient's symptoms of cough with mucopurulent sputum, dyspnea, orthopnea, headache, and crackles, along with cyanotic lips, indicate that the patient is experiencing difficulty breathing and may not be getting enough oxygen. Administering oxygen can help to increase the oxygen levels in the blood and improve the patient's respiratory function.7. The most likely diagnosis for this patient is (C) Ventilator associated pneumonia. The patient's symptoms of chest pain that intensifies with breathing, cough, dyspnea, crackles, elevated body temperature, and newly developed parenchymal opacity on chest radiography, along with the fact that the patient is intubated and in the intensive care unit, suggest that the patient has developed pneumonia as a complication of mechanical ventilation.8. The type of hypersensitivity that this patient has is (D) Type IV. The patient's symptoms of itching, burning sensation, weeping and formed crusts skin lesions on face and hands, and peeling of the skin are consistent with a delayed-type hypersensitivity reaction, which is a type IV hypersensitivity reaction.9. The most likely ART drug related to this side effect is (C) Zidovudine. The patient's symptoms of weakness, fatigue, and dizziness, along with a low hemoglobin level, suggest that the patient may be experiencing anemia. Zidovudine, an antiretroviral drug, is known to cause anemia as a side effect in some patients.

Question

Solution

Resposta