What intervention should the nurse identify as a priority for a client with a nursing diagnosis of ineffective airway clearance related to HIV related pneumonia?

Coughing and deep breathing and hydration maintenance

Keep the head of the bed elevated

Preparation for insertion of a tracheostomy tube

Provide supplemental oxygen

Answer and Explanation

The Correct Answer is A

Choice A rationale:
Coughing and deep breathing are essential for mobilizing and removing secretions from the airways, which is crucial for improving airway clearance in patients with pneumonia. These techniques help to loosen mucus and bring it up from the lungs, allowing it to be expelled through coughing.
Hydration maintenance is also critical because it helps to thin secretions, making them easier to cough up. Adequate hydration helps to keep mucus moist and less sticky, which promotes easier expectoration.
Choice B rationale:
Keeping the head of the bed elevated can help to improve oxygenation and reduce the work of breathing, but it does not directly address the issue of airway clearance. It may be a helpful adjunct intervention, but it's not the priority for this specific nursing diagnosis.
Choice C rationale:
Preparation for insertion of a tracheostomy tube is a more invasive intervention that may be necessary in severe cases of airway obstruction, but it is not the first-line intervention for ineffective airway clearance related to pneumonia. It would be considered if other measures fail to maintain adequate ventilation.

Choice D rationale:
Providing supplemental oxygen can help to improve oxygenation in patients with pneumonia, but it does not directly address the issue of airway clearance. It's important to support oxygenation, but it's not the primary intervention to clear secretions.

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Correct Answer is C

Explanation

Choice A rationale:
Pitting edema of the hands and fingers is not a typical finding in SLE. It can occur in some cases, but it is more commonly associated with other conditions such as kidney disease or heart failure.

Choice B rationale:
Grey colored, non-purpuric papular rash is not a characteristic of SLE. This type of rash is more commonly seen in conditions such as lichen planus or sarcoidosis.

Choice C rationale:
A dry, red rash across the bridge of the nose and on the cheeks, also known as a malar rash, is a classic sign of SLE. It is often described as a "butterfly rash" because of its shape. The rash is caused by inflammation of the small blood vessels in the skin. It is typically worsened by sun exposure.

Choice D rationale:
Subcutaneous nodules on the ulnar side of the arm are a characteristic finding in rheumatoid arthritis, not SLE.

A. Depression B. Deep sleep deprivation C. Cardiovascular disease D. Diuretic use

Correct Answer is ["C","D"]

Explanation

Cardiovascular disease (CVD) is a significant risk factor for gout. This is because CVD often coexists with other conditions that can elevate uric acid levels, such as hypertension, obesity, and chronic kidney disease. Additionally, some medications used to treat CVD, such as thiazide diuretics, can also increase uric acid levels.

Research has shown that people with CVD have a 2-3 times higher risk of developing gout compared to those without CVD.

The mechanisms linking CVD and gout are complex and not fully understood, but they likely involve shared pathways of inflammation and endothelial dysfunction.

Choice D rationale:

Diuretic use, particularly thiazide diuretics, is a well-established risk factor for gout. These medications work by increasing the excretion of fluids and electrolytes from the body, which can also lead to a decrease in the excretion of uric acid.

This can result in a buildup of uric acid in the blood, which can then crystallize in joints and cause gout attacks.

The risk of gout associated with diuretic use is dose-dependent, meaning that higher doses of diuretics are associated with a higher risk of gout.

Choice A rationale:

Depression has not been consistently shown to be an independent risk factor for gout.
Some studies have suggested a possible link between depression and gout, but others have not found any association. More research is needed to clarify the relationship between these two conditions.

Choice B rationale:

Deep sleep deprivation has not been studied as a risk factor for gout.
There is currently no evidence to suggest that it is directly associated with an increased risk of developing the disease.

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What intervention should the nurse identify as a priority for a client with a nursing diagnosis of ineffective airway clearance related to HIV related pneumonia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A clinic nurse is performing a physical assessment on a client who has systemic lupus erythematosus (SLE). Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

A nurse is discussing gout with a patient who is concerned about developing the disorder. Which of the following findings should the nurse identify as risk factors for this disease? Select all that applies.

Correct Answer is ["C","D"]

Explanation

Choice D rationale:

Choice A rationale:

Choice B rationale:

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