Nokea
A client has a newly inserted chest drainage system with a water seal. Which of the following actions should be taken?
- A. Clamp the tube when the client is ambulating.
- B. Keep the collection device below the level of the client's chest.
- C. Carefully coil the tubes to prevent kinking.
- D. Position the client flat to avoid leaks in the tubing.
Correct Answer: B
Rationale: The correct answer is B: Keep the collection device below the level of the client's chest. This is important to ensure proper drainage and prevent backflow or air from entering the pleural space. Placing the collection device below the chest allows gravity to assist in drainage. Clamping the tube while ambulating (choice A) can lead to increased pressure in the chest, risking complications. Coiling the tubes (choice C) may cause kinks, obstructing drainage. Positioning the client flat (choice D) can lead to leaks in the tubing due to elevated pressure.
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The healthcare provider is caring for a client who has heart failure and a history of asthma. The provider reviews the orders and recognizes that clarification is needed for which of the following medications?
- A. Carvedilol
- B. Fluticasone
- C. Captopril
- D. Isosorbide dinitrate
Correct Answer: B
Rationale: The correct answer is B: Fluticasone. Fluticasone is an inhaled corticosteroid used to treat asthma, which can worsen heart failure symptoms. The healthcare provider needs to clarify this medication due to the client's history of asthma and heart failure. Carvedilol (A) is a beta-blocker used to treat heart failure. Captopril (C) is an ACE inhibitor also used in heart failure. Isosorbide dinitrate (D) is a vasodilator used for heart failure and angina, not contraindicated in asthma.
A client is admitted for hemodialysis. Which abnormal lab value would the nurse anticipate not being improved by hemodialysis?
- A. Low hemoglobin.
- B. Hypernatremia.
- C. High serum creatinine.
- D. Hyperkalemia.
Correct Answer: A
Rationale: Hemodialysis does not directly improve anemia caused by low hemoglobin.
A client with chronic obstructive pulmonary disease is being taught by a nurse about ways to facilitate eating. Which of the following statements indicates a need for further teaching?
- A. I will rest for at least 30 minutes before eating.
- B. I will take my bronchodilators after meals.
- C. I will eat five or six small meals each day.
- D. I will choose foods that are not gas-forming.
Correct Answer: B
Rationale: The correct answer is B: "I will take my bronchodilators after meals." Taking bronchodilators after meals can decrease their effectiveness due to delayed absorption. Step 1: Bronchodilators should be taken before meals to open airways for better breathing. Step 2: Resting before meals (A) can reduce shortness of breath. Eating small meals (C) can prevent overeating and aid digestion. Choosing non-gas forming foods (D) can reduce bloating.
Denise is recovering from an open cholecystectomy. You know that because of the location of the surgery, she has an increased risk of postoperative:
- A. Myocardial infarction.
- B. Respiratory complications.
- C. Deep vein thrombosis.
- D. Wound infection.
Correct Answer: B
Rationale: Open cholecystectomy involves abdominal surgery, which can impair respiratory function due to pain and reduced mobility. This increases the risk of respiratory complications such as atelectasis or pneumonia.
During a family meeting, the patient's father called his son a bum because of his drug use and running afoul of the law. What is the best response?
- A. Anyone can become physiologically and psychologically dependent on drugs, which can result in drug-seeking behaviors that can lead to health, financial, family, and legal problems.
- B. Your son realizes his problem and is trying to change.
- C. Have you thought about going to family therapy?
- D. Have you heard about Nar-Anon or Al-Anon?
Correct Answer: A
Rationale: Educating the family about addiction reduces stigma and promotes understanding.