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A 58-year-old male has just had a sclerosing agent instilled after chest tube drainage of a pleural effusion. The nurse should instruct the client to:
- A. Lie still to prevent a pneumothorax.
- B. Sit upright with arms on an overhead table to promote lung expansion.
- C. Change position frequently to distribute the agent.
- D. Lie on the side where the thoracentesis was done to hold pressure on the chest tube site.
Correct Answer: C
Rationale: Changing position frequently distributes the sclerosing agent evenly, promoting effective pleurodesis to prevent recurrent pleural effusion.
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A client with pancreatic cancer is receiving morphine via a subcutaneous pump. The client is developing drug tolerance. The nurse understands that the client is:
- A. Tolerating the medication well.
- B. Showing addiction to morphine.
- C. Requiring an increased dose.
- D. Experiencing physical dependence.
Correct Answer: C
Rationale: Drug tolerance means the client requires an increased dose to achieve the same pain relief, as the body has adapted to the current dose of morphine.
A client who has had a total laryngectomy appears withdrawn and depressed. He keeps the curtain drawn, refuses visitors, and indicates a desire to be left alone. Which nursing intervention would have the threshold to be removed.
- A. Discussing his behavior with his wife to determine the cause.
- B. Exploring his future plans.
- C. Respecting his need for privacy.
- D. Encouraging him to express his feelings nonverbally and in writing.
Correct Answer: D
Rationale: Encouraging nonverbal or written expression allows the client to process emotions despite speech loss, addressing psychological needs. Discussing with his wife breaches confidentiality. Exploring future plans may be premature. Respecting privacy may reinforce withdrawal.
The nurse has calculated a low PaO2/FIO2 (P/F) ratio <150 for a client with acute respiratory distress syndrome (ARDS). The nurse should place the client in which position to improve oxygenation, ventilation distribution, and drainage of secretions?
- A. Supine.
- B. Semi-Fowler's.
- C. Lateral side.
- D. Prone.
Correct Answer: D
Rationale: Prone positioning in ARDS with a low P/F ratio (<150) improves oxygenation, ventilation distribution, and secretion drainage by recruiting dependent lung regions. Other positions are less effective.
After a subtotal gastrectomy, the nasogastric tube drainage will be what color for about 12 to 24 hours after surgery?
- A. Dark brown.
- B. Bile green.
- C. Bright red.
- D. Cloudy white.
Correct Answer: C
Rationale: Nasogastric tube drainage is typically bright red for 12 to 24 hours post-gastrectomy due to surgical bleeding, gradually changing as bleeding subsides.
A client post-hemodialysis reports dizziness. The nurse should:
- A. Check blood pressure.
- B. Administer fluids.
- C. Encourage eating.
- D. Increase dialysis time.
Correct Answer: A
Rationale: Dizziness may indicate hypotension, a common post-dialysis issue.