Nokea
Which diagnostic test should the nurse anticipate the health-care provider ordering to rule out the diagnosis of asthma in clients diagnosed with chronic obstructive pulmonary disease (COPD)?
- A. A bronchoscopy.
- B. An immunoglobulin E.
- C. An arterial blood gas.
- D. A bronchodilator reversibility test.
Correct Answer: D
Rationale: A bronchodilator reversibility test differentiates asthma from COPD by assessing whether airway obstruction is reversible. In asthma, lung function (e.g., FEV1) improves significantly post-bronchodilator, while COPD shows minimal improvement. Bronchoscopy (A) is invasive and not specific for this differentiation. Immunoglobulin E (B) is relevant for allergies, not distinguishing asthma from COPD. Arterial blood gases (C) assess oxygenation but do not differentiate these conditions.
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The nurse performs postural drainage on the client. Which nursing intervention is most beneficial to loosen secretions?
- A. Telling the client to take deep breaths
- B. Striking the back with a cupped hand
- C. Applying pressure below the diaphragm
- D. Placing the client in a sitting position
Correct Answer: B
Rationale: Striking the back with a cupped hand (percussion) helps loosen secretions during postural drainage.
The unlicensed assistive personnel (UAP) assists the client with a chest tube to ambulate to the bathroom. Which situation warrants immediate intervention from the nurse?
- A. The UAP keeps the chest tube below chest level.
- B. The UAP has the chest tube attached to suction.
- C. The UAP allowed the client out of the bed.
- D. The UAP uses a bedside commode for the client.
Correct Answer: B
Rationale: Suction during ambulation (B) restricts mobility and risks dislodgement, requiring intervention. Below chest level (A), ambulation (C), and commode (D) are appropriate.
An adult has a chest drainage system. Several hours after the chest tube was inserted, the nurse observes that there is no bubbling in the water seal chamber. What is the most likely reason for the absence of bubbling?
- A. The client's lungs have reexpanded.
- B. There is an obstruction in the tubing coming from the client.
- C. There is a mechanical problem in the pump.
- D. Air is leaking into the drainage apparatus.
Correct Answer: A
Rationale: No bubbling in the water seal chamber typically indicates lung reexpansion, as air is no longer leaking from the lung into the pleural space.
The nurse is preparing the client diagnosed with laryngeal cancer for a laryngectomy in the morning. Which intervention is the nurse's priority?
- A. Take the client to the intensive care unit for a visit.
- B. Explain that the client will need to ask for pain medication.
- C. Demonstrate the use of an antiembolism hose.
- D. Find out if the client can read and write.
Correct Answer: D
Rationale: Literacy (D) ensures post-laryngectomy communication (e.g., writing), a priority. ICU visit (A), pain requests (B), and TED hose (C) are secondary.
Which intervention should the nurse implement first for the client diagnosed with a hemothorax who has had a right-sided chest tube for three (3) days and has no fluctuation (tidaling) in the water compartment?
- A. Assess the client's bilateral lung sounds.
- B. Obtain an order for a STAT chest x-ray.
- C. Notify the health-care provider as soon as possible.
- D. Document the findings in the client's chart.
Correct Answer: A
Rationale: No tidaling may indicate resolution or obstruction; assessing lung sounds (A) confirms status. CXR (B), notification (C), and documentation (D) follow.