Question 1

A patient with acute bronchitis is being discharged with a prescription for an antimicrobial medication to be taken for the next 14 days.What should the nurse stress when providing discharge teaching?&#10;A) Take the drug on an empty stomach before meals.&#10;B) Complete the entire course as prescribed.&#10;C) Maintain a thorough oral hygiene regimen.&#10;D) Maintain a daily fluid intake of 500 mL.

Accepted Answer

It is important for the patient to complete the entire course of antimicrobial medication as prescribed, to ensure that the infection is fully treated and to prevent the development of antibiotic resistance. It is not necessary to take the medication on an empty stomach, but the patient should maintain good oral hygiene and an adequate fluid intake to support recovery.

Question 2

What should a nurse prepare when assessing paradoxical movement in a patient with a flail chest who has significant dyspnea?&#10;A) Thoracotomy&#10;B) Intubation&#10;C) Thoracentesis&#10;D) Body cast

Accepted Answer

Intubation may be necessary to help the patient breathe and stabilize their breathing pattern before further interventions, such as surgery or chest tube placement. Thoracotomy is a surgical procedure that may be necessary in severe cases of flail chest, but it is not typically the first intervention. Thoracentesis is a procedure to remove fluid from the pleural cavity, which would not address the paradoxical movement. A body cast would not be an appropriate intervention for a flail chest.

Question 3

Assessment of 24-year-old driver after an automobile accident, who is complaining of right-sided chest pain and is dyspneic, reveals the following:
• Respirations: 26 breaths/min
• Significant pain on inspiration
• Hand is pressed to the rib area; large bruise is forming on the right chest
• Blood pressure: 182/98 mm Hg
Based on these assessments, the nurse suspects _____ ribs.

fractured

Accepted Answer

fractured

Question 4

A patient comes to the emergency department with a sucking chest wound.Which type of dressing should the nurse apply to begin the process of lung reinflation?&#10;A) Petroleum dressing covered with an airtight bandage&#10;B) No dressing at all&#10;C) Pillow weighted down with a sandbag&#10;D) Air-occlusive dressing taped on three sides (vented dressing)

Accepted Answer

An air-occlusive dressing taped on three sides (vented dressing) is the best choice for a patient with a sucking chest wound. This type of dressing allows air to escape when the patient exhales, but prevents air from entering the chest cavity during inhalation, which aids in lung reinflation. The other options (petroleum dressing covered with an airtight bandage, no dressing, and a pillow weighted down with a sandbag) are inappropriate and may exacerbate the patient's condition.

Question 5

What action should a nurse implement to reduce the risk of aspiration in a patient receiving continuous enteral feedings at a rate of 70 mL/hr?&#10;A) Check the position of the tube during every shift.&#10;B) Notify the charge nurse or physician about a residual volume of 20 mL.&#10;C) Elevate the patient's head during and for 10 minutes after feeding.&#10;D) Position the patient on the left side after the feeding.

Accepted Answer

The answer of What action should a nurse implement to...

Question 6

Which intervention would be inappropriate for decreasing the risk of further emboli in a patient with a pulmonary embolism?&#10;A) Carefully applying compression stockings&#10;B) Performing passive range-of-motion exercises, especially of the lower limbs&#10;C) Placing pillows under the knees to elevate the legs&#10;D) Ambulating frequently

Accepted Answer

Placing pillows under the knees to elevate the legs may actually increase the risk of emboli formation as it can cause blood to pool in the legs and potentially form clots. The other interventions listed (compression stockings, passive range-of-motion exercises, and frequent ambulation) all help to promote blood flow and prevent clot formation.

Question 7

Which group of patients should a nurse advise to have a vaccination with conjugated pneumococcal?&#10;A) Adults with diabetes&#10;B) Persons 65 years and older&#10;C) Parents of children younger than 24 months&#10;D) Persons with cardiovascular disorders

Accepted Answer

Parents of children younger than 24 months should be advised to have a vaccination with conjugated pneumococcal.

Question 8

What symptoms should a nurse expect to see in a patient with hypoxemia?&#10;A) Restlessness, tachycardia, and tachypnea&#10;B) Bradycardia, cyanosis, and restlessness&#10;C) Dyspnea, flushed face, and tachycardia&#10;D) Cyanosis, nausea, and bradycardia

Accepted Answer

Restlessness, tachycardia, and tachypnea are all typical signs of hypoxemia. Bradycardia and nausea are not usually associated with hypoxemia, whereas cyanosis and dyspnea (shortness of breath) can also be present but may not always be seen. Flushed face is not a common symptom of hypoxemia.

Deck 27: Acute Lower Respiratory Tract Disorders