Critical Care Respiratory Questions

Critical Care Respiratory Questions Related

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A client who has endometrial cancer is receiving sealed internal radiation therapy. Which actions should the nurse implement? Select one that doesn't apply.

  • A. Wear a lead apron when providing care.
  • B. Remove soiled dressings from the room.
  • C. Instruct visitors to wear a dosimeter badge.
  • D. Place dislodged source in biohazard container.
Correct Answer: C

Rationale: 1. Wearing a lead apron when providing care is recommended to protect the caregiver from radiation exposure. Always keep the front of the apron facing the client and do not turn so that the back of the caregiver is facing the client. 5. Women who are pregnant (including caregivers) should not enter the room. In addition, if the caregiver is attempting to conceive, whether they are male or female, they should not perform direct client care. Children younger than 16 should not be allowed to visit either. A 'Caution: Radioactive Material' sign should be placed on the door to the client’s room.

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During an admission assessment a client responds with rhyming statements such as 'tip, rip, dip and hip'. The nurse recognizes this speech pattern is associated with which mental health disorder?

  • A. Mania
  • B. Anxiety
  • C. Depression
  • D. Schizophrenia
Correct Answer: D

Rationale: This speech pattern is associated with psychotic disorders and schizophrenia. The client is exhibiting a type of speech called Clang association which is the meaningless rhyming of words, often in a forceful manner.

A nurse is evaluating a client's use of a cane. Which of the following actions should the nurse identify as an indication of correct use?

  • A. The top of the cane is parallel to the client's waist.
  • B. When walking, the client moves the cane 46 cm forward
  • C. The client holds the cane on the stronger side of her body.
  • D. The client moves her stronger limb forward with the cane.
Correct Answer: C

Rationale: The client should hold the cane on the stronger side of her body to increase support and maintain alignment. The top of the cane should be parallel to the greater trochanter, the client should only advance the cane 14-30 cm at a time, the client should move the weak leg with the cane for support.

Doctor's order: 750 mL NS to infuse over 8 hours. How many mL/hr will you set the IV pump? Round to the nearest whole number.

  • A. 94
  • B. 93
  • C. 95
  • D. 49
Correct Answer: A

Rationale: 750 mL ÷ 8 hr = 93.75 mL/hr, rounded to 94 mL/hr.

The nurse is performing nasotracheal suctioning of a client. What should the nurse do when suctioning this client?

  • A. Apply suction for 5-10 seconds.
  • B. Plan to suction for 10 minutes.
  • C. Apply suction while inserting the catheter.
  • D. Apply suction for 20-30 seconds.
Correct Answer: A

Rationale: Nasotracheal suctioning should apply suction for 5-10 seconds (A) to minimize hypoxia and trauma with intermittent suctioning. Suctioning for 10 minutes (B) is excessive and dangerous. Applying suction during insertion (C) risks mucosal damage. 20-30 seconds (D) is too long increasing hypoxia risk making A the correct technique.

A nurse is caring for a client who has a sodium level of 125 mEq/L. Which of the following findings should the nurse expect?

  • A. Numbness of the extremities
  • B. Bradycardia
  • C. Positive Chvostek’s sign
  • D. Abdominal cramping
Correct Answer: D

Rationale: Abdominal cramping. Low sodium level manifests as cramping, weakness, confusion, and lethargy. Chvostek’s sign is a manifestation of hypomagnesemia and hypocalcemia. Tachycardia is a manifestation of hyponatremia along with hypovolemia.