Nokea
A client is having a left pneumonectomy. In planning this client's postoperative care, nursing interventions for a postoperative left pneumonectomy would include:
- A. monitoring the chest tubes.
- B. positioning the client on the right side.
- C. positioning the client in the semi-Fowler's position with a pillow under the shoulder and back.
- D. monitoring the right lung for an increase in rales.
Correct Answer: D
Rationale: Chest tubes are not usually necessary in a pneumonectomy, because there is no lung to re-expand on the operative side. The pneumonectomy client should be positioned on the back or operated side, because the sutured bronchial stump may open, which would allow fluid to drain into the unoperated side and drown the client. The client should not have a pillow under the shoulder and back, because of the subscapular incision. Rales are commonly heard over the base of the remaining lung. An increase could indicate circulatory overload. Rales should be closely monitored.
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Ken Thom needs instruction on the medications he is taking for his hypothyroidism. You would include which of the following in a teaching plan?
- A. Take medications with meals or with food.
- B. Take medications in the evening or at bedtime.
- C. Report excess weight loss and leg cramps.
- D. Increase the use of iodized salt and spinach.
Correct Answer: C
Rationale: Thyroid medications will be absorbed better if taken on an empty stomach. Thyroid medications would best be taken in the morning, as they may cause difficulty in sleeping when taken at night. Weight loss should occur, but the patient should be taught to report an excessive loss. Leg cramps may indicate a calcium disturbance that needs correction. Iodine is an antithyroid, decreasing thyroid function. Increasing intake of thyroid would effectively act as an antidote to the thyroid medications Mr. Thom is taking.
A client is prescribed prednisone for asthma management. Which statement by the client indicates a need for further teaching?
- A. I will take this medication every day to prevent asthma attacks.
- B. I will avoid people with infections while taking this medication.
- C. I will take this medication with food to prevent stomach upset.
- D. I will stop taking this medication if I feel fine.
Correct Answer: D
Rationale: The correct answer is D because stopping prednisone abruptly can lead to adrenal insufficiency due to the suppression of the body's natural cortisol production. The client should never stop taking prednisone suddenly without consulting the healthcare provider. Choice A is correct because prednisone is often used as a daily preventive medication for asthma. Choice B is correct as prednisone can lower the immune system, making the client more susceptible to infections. Choice C is incorrect because prednisone is usually taken with food to minimize stomach upset.
Which energy medicine technique promotes healing using electricity, magnets, or both?
- A. Reiki
- B. Acupuncture
- C. Electromagnetic therapy
- D. Chiropractic therapy
Correct Answer: C
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is scheduled to have a tracheostomy placed in an hour. What action by the nurse is the priority?
- A. Administer prescribed anxiolytic medication.
- B. Ensure informed consent is on the chart.
- C. Reinforce any teaching done previously.
- D. Start the preoperative antibiotic infusion.
Correct Answer: B
Rationale: The correct answer is B: Ensure informed consent is on the chart. This is the priority because obtaining informed consent is essential to ensure the client understands the procedure, risks, benefits, and alternatives. It protects the client's autonomy and ensures legal and ethical standards are met. Administering anxiolytic medication may help with anxiety but does not address the crucial issue of consent. Reinforcing teaching and starting antibiotics are important but secondary to obtaining informed consent.
In planning Mr. Jones’ discharge teaching, what is important to emphasize?
- A. He should not leave his home without wearing a mask
- B. Medications must be taken as ordered
- C. All visitors to his home should wear masks
- D. He is cured of tuberculosis
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.