Nokea
In which way should a patient be positioned after a thoracentesis is completed and the dressing applied?
- A. High Fowler
- B. Semi-Fowler
- C. Side lying on unaffected side
- D. Prone
Correct Answer: C
Rationale: After a thoracentesis, the patient is placed in a side-lying position on the unaffected side.
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Which instruction by the nurse is inappropriate for teaching the proper technique for collection of a sputum specimen?
- A. Bring the sputum up from the lungs.
- B. Rinse mouth with water before expectorating in specimen cup.
- C. Collect specimens after meals.
- D. Send specimen to the lab without delay.
Correct Answer: C
Rationale: Collecting specimens before meals will avoid possible emesis from coughing after eating.
The patient with long-term emphysema is admitted with a secondary diagnosis of cor pulmonale. Which symptoms will the patient likely exhibit?
- A. Edema of the lower extremities and extended neck veins due to hypertension of the pulmonary circulation.
- B. A dry hacking cough and chest pain due to constriction of the pulmonary vein.
- C. Hypertension and a headache related to pulmonary hypertension.
- D. Unlabored respiration and cyanosis around the mouth.
Correct Answer: A
Rationale: COPD can lead to cor pulmonale, an abnormal cardiac condition characterized by hypertrophy of the right ventricle of the heart as a result of hypertension of the pulmonary circulation. Cor pulmonale results in the presence of edema in the lower extremities, as well as in the sacral and perineal area, distended neck veins, and enlargement of the liver with ascites.
The patient who had a bronchoscopy 1 hour ago asks when eating will be possible. Which response would be most helpful?
- A. In 24 hours, but must take cold liquids for the rest of the day
- B. If there is no blood in his sputum
- C. In 8 hours after a period of nothing by mouth
- D. When the gag reflex returns
Correct Answer: D
Rationale: Following a bronchoscopy, the patient can eat as soon as the gag reflex returns, usually in about 2 hours.
The nurse explains that the opening between the vocal cords is the ___.
Correct Answer: glottis
Rationale: The glottis is the opening between the vocal cords.
The older adult patient with long-term emphysema reports experiencing a sharp pleuritic pain after a severe period of coughing. The patient's heart rate and respiratory rate have increased. Auscultation reveals no breath sounds on the left side. These are signs and symptoms of which condition?
- A. Pulmonary embolus
- B. Spontaneous pneumothorax
- C. Early signs of unilateral pneumonia
- D. An attack of asthma
Correct Answer: B
Rationale: Spontaneous pneumothorax can be caused by a ruptured bleb in a patient with long-term emphysema. The disorder causes chest pain, dyspnea, and anxiety associated with air hunger.