Nokea
A nurse cares for a client who is prescribed an intravenous prostacyclin agent. Which actions should the nurse take? (Select all that apply.)
- A. Keep an intravenous line dedicated strictly to the infusion.
- B. Teach the client that this medication increases pulmonary pressures.
- C. Ensure that there is always a backup drug cassette available.
- D. Start a large-bore peripheral intravenous line.
- E. Use strict aseptic technique when using the drug delivery system.
Correct Answer: A,C,E
Rationale: Prostacyclin should be administered via a dedicated central venous catheter with strict aseptic technique to prevent infection. A backup cassette is essential due to risks of interruption. The medication decreases pulmonary pressures, and a central line, not peripheral, is used.
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A nurse cares for a client who has a pleural chest tube. Which action should the nurse take to ensure safe use of this equipment?
- A. Strip the tubing to minimize clot formation and ensure patency.
- B. Secure tubing junctions with clamps to prevent accidental disconnections.
- C. Connect the chest tube to wall suction at the level prescribed by the provider.
- D. Keep padded clamps at the bedside for use if the drainage system is interrupted.
Correct Answer: D
Rationale: Keeping padded clamps at the bedside ensures safety if the drainage system is interrupted. Stripping the tubing can cause harm, junctions should be taped not clamped, and suction levels are set per the device manufacturer, not the provider.
A nurse cares for a client who has developed esophagitis after undergoing radiation therapy for lung cancer. Which diet selection should the nurse provide for this client?
- A. Spaghetti with meat sauce, ice cream
- B. Grilled cheese sandwich with whole wheat bread
- C. Oatmeal with skim milk, custard
- D. Pasta salad, custard, orange juice
Correct Answer: C
Rationale: Side effects of radiation therapy may include esophagitis. Oatmeal with skim milk and custard are soft, non-irritating foods suitable for a client with esophagitis. Spaghetti with meat sauce may be too spicy, grilled cheese sandwiches are too difficult to swallow, and orange juice is too caustic due to its citric acid content.
While assessing a client who is 12 hours postoperative after a thoracotomy for lung cancer, a nurse notices that the lower chest tube is dislodged. Which action should the nurse take first?
- A. Assess for drainage from the site.
- B. Cover the insertion site with sterile gauze.
- C. Contact the provider and obtain a suture kit.
- D. Reinsert the tube using sterile technique.
Correct Answer: B
Rationale: Covering the insertion site with sterile gauze prevents air from entering the pleural space, which could cause a pneumothorax. Assessing drainage, contacting the provider, or reinserting the tube are secondary actions after securing the site to prevent complications.
The nurse instructs a client on the steps needed to obtain a peak expiratory flow rate. In which order should these steps occur? 1. Take as deep a breath as possible. 2. Stand up (unless you have a physical disability). 3. Place the meter in your mouth, and close your lips around the mouthpiece. 4. Make sure the device reads zero or is at base level. 5. Blow out as hard and as fast as possible for 1 to 2 seconds. 6. Write down the value obtained. 7. Repeat the process two additional times, and record the highest number in your chart.
- A. 4,2,1,3,5,6,7
- B. 1,2,3,4,5,6,7
- C. 2,1,3,4,5,6,7
- D. 1,3,2,5,6,7,4
Correct Answer: A
Rationale: The correct order is: ensure the device is at zero (4), stand up (2), take a deep breath (1), place the meter in the mouth (3), blow out hard and fast (5), record the value (6), and repeat twice, recording the highest value (7).
The nurse is caring for a client with lung cancer who states, 'I don't want any pain medication because I am afraid to become addicted.' How should the nurse respond?
- A. I will ask the provider to change your medication to a drug that is less potent.
- B. I will ask the provider to prescribe a non-opioid analgesic.
- C. It is unlikely you will become addicted when taking medicine for pain.
- D. I will discuss alternative pain relief methods like acupuncture.
Correct Answer: C
Rationale: The risk of addiction is low when pain medications are used appropriately for pain management in clients with cancer. Changing to a less potent drug or non-opioid may not adequately address pain. Alternative methods like acupuncture may be considered but are not the priority response.