Which finding would indicate to the nurse

Which finding would indicate to the nurse improvement in a client whose chronic obstructive pulmonary disease (COPD) is medically managed with corticosteroids and bronchodilators? Select all that apply. Absent cough Pulse oximetry greater than 92% on room air Decreased resting respiratory rate Lungs clear bilaterally Tolerating ambulation 8.Which finding requires additional evaluation by the nurse in the immediate postoperative care of a client who has a lung resection for malignancy and has a closed chest tube drainage system to suction? Rapid bubbling in the water seal chamber A column of water 20 cm high in the suction control chamber An intact occlusive dressing at the insertion site 75 mL of bright red blood in the drainage collection chamber 9. Which action is the priority when a client’s chest tube has accidentally become dislodged? Positioning the client on the left side Apply a petroleum/Vaseline gauze dressing over the site Prepare to re-insert a new chest tube Initiate oxygen via non-rebreather mask 10. The nurse is caring for a patient who has a chest tube to drain a pneumothorax. Which actions should the nurse perform? Select all that apply. Milk the chest tube to increase drainage If the tube becomes disconnected, ask the patient to cough and exhale as much as possible. Fill the water seal chamber up to the mark specified by the manufacturer, and observe it. Clamp the chest tube when the patient is moving about Keep the drainage below the patient’s chest level 11. Which precautions would the nurse take when caring for a client with tuberculosis (TB)? Don a surgical mask with a face shield when entering the room Wear an N95 respirator when caring for the client Put on a gown when entering the room Place the client with another client who has TB 12. Which statement by a client with tuberculosis on a protocol that includes rifampin indicates that the teaching about rifampin was effective? “I can expect my urine to turn orange from this medication.” “I need to drink a lot of fluid while I take this medication.” “I might get a skin rash because it is an expected side effect of this medication.” “I should have my hearing tested while I take this medication.” 13. Which sign or symptom is specific to pulmonary edema? Select all that apply Coughing Crackles Dependent edema in the legs Dyspnea Pink-Frothy Sputum 14. The practical nurse has been assigned a client with a history of chronic obstructive pulmonary disease (COPD) who has been admitted to the hospital with a medical diagnosis of pneumonia. Which intervention poses the greatest risk of respiratory depression for a client with a history of COPD? Chest physiotherapy and nebulizers performed every 4 to 6 hours. Administration of acetaminophen 600 mg every 4 hours as needed for fever. Oxygen administration via nasal cannula 4 L/m. Vancomycin 500 mg administered intravenously every 6 to 8 hours. 15. An experienced LPN/LVN, under the supervision of the team leader RN, is providing nursing care for a patient with a respiratory problem. Which actions are appropriate to the scope of practice of an experienced LPN/LVN? (Select all that apply.) Evaluating the patient’s technique for using MDIs Auscultating breath sounds Completing in-depth admission assessment Checking oxygen saturation using pulse oximetry Developing the nursing care plan Administering medications via metered-dose inhaler (MDI) 16. The patient with COPD tells the UAP that he did not get his annual flu shot this year and has not had a pneumonia vaccination. You would be sure to instruct the UAP to report which vital sign value? Heart rate of 92 beats/min Oral temperature of 101.2° F (38.4°C) Respiratory rate of 27 breaths/min Blood pressure of 152/84 mm Hg 17. You are initiating a nursing care plan for a patient with pneumonia. Which intervention for cough enhancement should you delegate to the UAP? Teaching the patient about the importance of adequate fluid intake and hydration Assisting the patient to a sitting position with neck flexed, shoulders relaxed, and knees flexed Reminding the patient to use an incentive spirometer every 1 to 2 hours while awake Encouraging the patient to take a deep breath, hold it for 2 seconds, then cough two or three times in succession 18. A patient with a pulmonary embolus is receiving anticoagulation with IV heparin. What instructions would you give the UAP who will help the patient with ADLs? (Select all that apply.) Be sure the patient’s footwear has a firm sole when the patient ambulates. Use a soft-bristled toothbrush or tooth sponge for oral care. Use a lift sheet when moving and positioning the patient in bed. Use an electric razor when shaving the patient each day. Use a rectal thermometer to obtain a more accurate body temperature. 19. The nurse caring for a patient who has a closed chest drainage system notes that there is fluctuation (tidaling) in the water seal chamber. What is the most appropriate nursing action based on this assessment? Elevate the head of the bed and notify charge nurse of malfunction of drainage system. Add more sterile water to the water seal chamber. Turn patient to the affected side. 20. A patient is on postoperative day 2 after undergoing a total hip replacement. The patient suddenly complains of chest pain and is coughing up blood-tinged sputum. What should be the nurse’s initial intervention? Increase IV flow rate. Report signs to the charge nurse. Prevent patient from excessive coughing. Elevate head of bed and administer oxygen. 21. A 55-year-old man comes to the health nurse at his place of work with epistaxis. He reports he has frequent nosebleeds that he can usually control himself. What would be the most helpful assessment after the nurse has stopped the bleeding? Inquire about a headache. Obtain a blood pressure. Record the approximate amount of blood lost. Record the last episode of epistaxis. 22. A patient problem for the patient with a new laryngectomy would be Social isolation related to impaired verbal communication related to removal of the larynx. What is an appropriate nursing intervention? Offer books or jigsaw puzzles for entertainment. Provide a pad and pencil or magic slate. Complete care quickly. Refrain from conversations with the patient to reduce stress level. SCIENCE HEALTH SCIENCE NURSING PN1 23

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