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In assisting a physician to perform a thoracentesis to Mr. Sy, how should the nurse postion a patient with pleural effusion of the left lung?
- A. supine with the left arm extended over the head
- B. sitting at the side of the bed with both arms resting on alocked overbed table
- C. high fowler's with both arms resting on pillows
- D. semi-fowlers with both arms resting on pillows
Correct Answer: B
Rationale: In performing a thoracentesis for a patient with pleural effusion of the left lung, the patient should be positioned sitting at the side of the bed with both arms resting on an overbed table. This position allows for better access to the left lung area and helps the patient maintain a comfortable and stable position during the procedure. Sitting position also helps to expand the intercostal spaces, making it easier for the physician to access the pleural fluid. Additionally, having both arms resting on an overbed table helps the patient remain still and reduce the risk of injury during the procedure. Therefore, this position is the most suitable for performing a thoracentesis for a patient with pleural effusion of the left lung.
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Which is a major complication in a child with chronic renal failure?
- A. Hypokalemia
- B. Metabolic alkalosis
- C. Water and sodium retention
- D. Excessive excretion of blood urea nitrogen
Correct Answer: C
Rationale: A major complication in a child with chronic renal failure is water and sodium retention, leading to fluid overload and hypertension. Because the kidneys are not functioning properly, they are unable to regulate fluid and sodium levels in the body effectively. This can result in edema, increased blood pressure, and potential heart complications. Monitoring and managing fluid and sodium intake are essential in managing this complication in children with chronic renal failure.
During an ophthalmic assessment, which of the ff are the nurses expected to observe carefully? Choose all that apply
- A. Level of central vision
- B. Pupil responses
- C. External eye appearance
- D. Eye movements
Correct Answer: B
Rationale: During an ophthalmic assessment, the nurses are expected to observe the following carefully:
When instructing the client diagnosed with hyperparathyroidism about diet, the nurse should stress the importance of which of the following?
- A. Restricting fluids
- B. Forcing fluids
- C. Restricting sodium
- D. Restricting potassium
Correct Answer: C
Rationale: For clients diagnosed with hyperparathyroidism, it is important to restrict sodium in the diet. High sodium intake can worsen calcium loss from the bones and increase the risk of kidney stones, both of which are concerns for individuals with hyperparathyroidism. Therefore, it is crucial to advise the client to limit their sodium intake to help manage their condition effectively.
The nurse is caring for a 32-year old client admitted with pernicious anemia. Which set of findings should the nurse expect when assessing the client?
- A. Pallor, bradycardia, and reduced pule
- B. Sore tongue, dyspnea, and weight gain
- C. Angina, double vision, and anorexia
- D. Pallor, tachycardia, and a sore tongue
Correct Answer: D
Rationale: Pernicious anemia is a type of megaloblastic anemia caused by the body's inability to absorb vitamin B12, essential for the production of red blood cells. The characteristic findings associated with pernicious anemia include pallor due to decreased red blood cells, tachycardia as the heart compensates for decreased oxygen-carrying capacity, and a sore tongue (glossitis) due to vitamin B12 deficiency affecting the oral mucosa. Therefore, the nurse should expect to find pallor, tachycardia, and a sore tongue when assessing a client with pernicious anemia.
The nurse is assisting the family of a child with a history of encopresis. Which should be included in the nurse's discussion with this family?
- A. Instruct the parents to sit the child on the toilet at twice-daily routine intervals.
- B. Instruct the parents that the child will probably need to have daily enemas.
- C. Suggest the use of stimulant cathartics weekly.
- D. Reassure the family that most problems are resolved successfully, with some relapses during periods of stress.
Correct Answer: D
Rationale: The most appropriate response for the nurse to include in the discussion with the family of a child with a history of encopresis is to reassure them that most problems are resolved successfully, with some relapses during periods of stress. Encopresis is a common disorder in childhood, characterized by the repeated passage of feces in inappropriate places. It is often related to chronic constipation and fecal impaction. Treatment for encopresis includes addressing the underlying constipation through interventions like dietary changes, behavioral therapies, and possibly medications. It is important for the nurse to educate the family that although it may take time and effort, most children improve with treatment. Reassuring the family that relapses during periods of stress are to be expected can help to alleviate some of their anxiety and encourage them to continue with the treatment plan.