Pulmonary NCLEX

Which of the following is the most accurate statement regarding the functions of protein? 1)Proteins can be used as coenzyme factors during cell metabolism. 2) Proteins are a necessary nutrient to provide energy for the body in times of stress. 3)Proteins can be a primary fuel source even if there is adequate carbohydrate intake., 4) Proteins are essential to tissue building and repair within the body.

4) Proteins are essential to tissue building and repair within the body.

Which assessment is important for the nurse to monitor in a client receiving total parenteral nutrition (TPN)? O Blood glucose O Occult blood in stool O Urine specific gravity O Presence of bowel sounds

Blood Glugose

During the administration of total parenteral nutrition (TPN), an assessment of the client reveals a bounding pulse, distended jugular veins, dyspnea, and cough. Which nursing intervention is the priority at this time?

Interrupt the client's infusion and notify the HCP

The nurse instructs the client admitted for an acute exacerbation of chronic obstructive pulmonary disease (COPD) about the importance of assessing for right-sided heart failure after discharge. What does the nurse instruct the client to assess for? 1 Increased appetite 2 Clubbing of the nail beds 3 Hypertension Correct4 Weight gain The most common signs and symptoms of right-sided heart failure are hepatomegaly, weight gain, jugular vein distention, and peripheral edema. Clients with right-sided heart failure often have decreased appetites. Clubbing is indicative of hypoxemia. Hypertension is associated with left-sided heart failure.

Weight Gain

An older client with the diagnosis of dementia is admitted to a long-term care facility. The client is confused and forgetful, wanders, and has intermittent episodes of urinary incontinence. Which nursing intervention will best meet this client's elimination needs? 1 By pointing out the behavior to the client 2 By obtaining incontinence pads for the client 3 By taking the client to the bathroom at regular intervals 4 By encouraging the client to call for help when there is an urge to urinate

3 By taking the client to the bathroom at regular intervals

Which mode of transmission would a nurse include in a teaching session for clients with fungal infections when explaining how tinea infections are spread?

3. Direct contact or by inanimate objects

Which statement made by the nurse is correct regarding total parenteral nutrition? O "The risks associated with total parenteral nutrition are minimal. "O "The client will still need to eat healthy meals while getting total parenteral nutrition." O "Only clients who cannot consume meals orally are candidates for total parenteral nutrition." O "Total parenteral nutrition must be administered through a central intravenous catheter."

"Total parenteral nutrition must be administered through a central intravenous catheter." Total parenteral nutrition must be administered via a large-bore central intravenous catheter. Total parenteral nutrition has several high-risk complications associated with it, including sepsis, phlebitis, fluid and electrolyte imbalances, hyperglycemia or hypoglycemia, metabolic disturbances, and osteomalacia. The client may still eat while getting total parenteral nutrition, but often it is prescribed for those who cannot consume meals orally. Total parenteral nutrition can be administered to clients who are able to eat orally to supplement their intake or nutrient status.

Which surgical procedure is appropriate for the removal of a vocal cord due to laryngeal cancer? 1 Cordectomy 2 Tracheotomy 3 Total laryngectomy 4 Oropharyngeal resections

1 Cordectomy A cordectomy is a surgical procedure performed in clients with laryngeal cancer; this surgery involves the removal of a vocal cord. A tracheotomy is a surgical incision in the trachea for the purpose of establishing an airway. A total laryngectomy is a surgical procedure in which the entire larynx, hyoid bone, strap muscles, and one or two tracheal rings are removed. A nodal neck dissection is also done in a total laryngectomy if the nodes are involved. An oropharyngeal resection is a surgical procedure performed to treat cancer of the oropharynx.

A nurse provides smoking-cessation education to a client with chronic obstructive pulmonary disease (COPD). The nurse concludes that the client is ready to quit smoking when the client makes which statement? 1 "I'll just finish the carton that I have at home." Correct 2 "I'll cut back to a half pack a day." 3 "I find that smoking is the only way I can relax." 4 "I should find this easy because I don't smoke when I drink." The response "I'll cut back to a half pack a day" is a positive step in reducing smoking [1] [2]; it is the first step toward stopping. The response "I'll just finish the carton that I have at home" is postponing the decision to quit. The response "I find that smoking is the only way I can relax" is rationalizing why quitting smoking is too difficult. The response "I should find this easy" is unrealistic because giving up smoking is difficult regardless of whether the client smokes when alcoholic beverages are consumed.

2 "I'll cut back to a half pack a day." The response "I'll cut back to a half pack a day" is a positive step in reducing smoking [1] [2]; it is the first step toward stopping. The response "I'll just finish the carton that I have at home" is postponing the decision to quit. The response "I find that smoking is the only way I can relax" is rationalizing why quitting smoking is too difficult. The response "I should find this easy" is unrealistic because giving up smoking is difficult regardless of whether the client smokes when alcoholic beverages are consumed.

Following surgery in the inguinal area, the client reports pain on the right side of the chest, becomes dyspneic, and begins to cough violently. The nurse suspects that a pulmonary embolus has occurred. Which is the priority nursing action? 1 Auscultate the chest 2 Obtain the vital signs Correct3 Elevate the head of the bed 4 Position the client on the right side Elevating the head of the bed promotes breathing by reducing the pressure of the abdominal organs on the diaphragm and increasing thoracic excursion. Auscultating the chest may confirm diminished breath sounds but will not facilitate breathing. Obtaining the vital signs should be done eventually, but it is not the priority. Positioning the client on the right side will impede aeration of the right lung fields.

3. Elevating head of head Elevating the head of the bed promotes breathing by reducing the pressure of the abdominal organs on the diaphragm and increasing thoracic excursion. Auscultating the chest may confirm diminished breath sounds but will not facilitate breathing. Obtaining the vital signs should be done eventually, but it is not the priority. Positioning the client on the right side will impede aeration of the right lung fields.

A nurse is teaching menu planning to a client who has a high triglyceride level. Which food avoided by the client indicates that teaching about foods that are high in saturated fat was understood? 1 Fruits 2 Grains 3Red meat 4Vegetable oils Red meat is high in dense saturated fats and should be avoided. Fruits do not contain saturated fats. Grains do not contain saturated fats. Vegetable oils contain unsaturated fats.

3. Red meat Red meat is high in dense saturated fats and should be avoided. Fruits do not contain saturated fats. Grains do not contain saturated fats. Vegetable oils contain unsaturated fats.

A client is scheduled for a preoperative electrocardiogram (EKG) tomorrow. The nurse should advise the client: a. No special preparation is required. b. Extreme exercise should be avoided. c. Consumption of glucose-rich food and fluids is encouraged. d. Sexual intercourse should be avoided.

A. No special preparation is required

During the first 36 hours after the insertion of chest tubes, when assessing the function of a three-chamber, closed-chest drainage system, the nurse identifies that the water in the underwater seal tube is not fluctuating. What initial action should the nurse take? 1 Take the client's vital signs. 2 Inform the healthcare provider. 3 Turn the client to the unaffected side. 4 Check the tube to ensure that it is not kinked. Once the drainage tube is patent, the fluctuation in the water column will resume; a lack of fluctuation because of lung reexpansion is unlikely 36 hours after a traumatic open chest injury. Taking the client's vital signs may be done eventually but is not the priority at this time. Informing the healthcare provider is unnecessary at this time; the chest tube is occluded, and nursing interventions should be attempted first. Turning the client to the unaffected side will compromise aeration of the unaffected lung.

Check the tube to ensure that it is not kinked Rationale: Once the drainage tube is patent, the fluctuation in the water column will resume; a lack of fluctuation because of lung reexpansion is unlikely 36 hours after a traumatic open chest injury. Taking the client's vital signs may be done eventually but is not the priority at this time. Informing the healthcare provider is unnecessary at this time; the chest tube is occluded, and nursing interventions should be attempted first. Turning the client to the unaffected side will compromise aeration of the unaffected lung.

Which factor would a nurse reference when teaching a client about the differences between the terms saturated fat and unsaturated fat?O Taste O Color O Density O Digestibility

Density Saturated fats are found in animal tissue and are more dense than unsaturated fats (found in vegetable oils). Taste, color, and digestibility are characteristics of food and have no bearing on fat saturation.

A nurse is caring for a client who just had a gastrectomy. Which client teaching would the nurse emphasize when discussing how to avoid dumping syndrome? Drink at least 2 to 3 glasses of fluid with each meal, Sit in a high-Fowler position for 30 minutes after eating Eat small meals with low-carbohydrate moderate-fat content, Increase activity after eating,

Eat small meals with low-carbohydrate moderate-fat content,

Which physiologic response would the nurse mention when providing discharge teaching about the signs and symptoms of dumping syndrome after a circumgastric banding bariatric surgical procedure? O Fever O Vomiting O Palpitations/Tachycardia O Constipation

Palpitations Dumping syndrome is caused by a rapid emptying of gastric contents into the small intestine, resulting in a constellation of vasomotor responses, including tachycardia, vertigo, syncope, diaphoresis, and pallor. Fever is a sign of infection, not dumping syndrome. Vomiting is not a sign of dumping syndrome; excessive food intake may result in nausea and vomiting. Diarrhea and abdominal cramping occur, not constipation.

A client who has acquired human immunodeficiency syndrome (HIV) develops bacterial pneumonia. On admission to the emergency department, the client's PaO2 is 80 mm Hg. When the arterial blood gases are drawn again, the level is determined to be 65 mm Hg. What should the nurse do first? 1 Prepare to intubate the client. 2 Increase the oxygen flow rate per facility protocol. 3 Decrease the tension of oxygen in the plasma. 4 Have the arterial blood gases redone to verify accuracy. This decrease in PaO2 indicates respiratory failure; it warrants immediate medical evaluation. Most facilities have a protocol to increase the oxygen flow rate to keep oxygen saturation greater than 92%. The client PaO2 of 65 mm Hg is not severe enough to intubate the client without first increasing flow rate to determine if the client improves. Decreasing the tension of oxygen in the plasma is inappropriate and will compound the problem. The PaO2 is a measure of the pressure (tension) of oxygen in the plasma; this level is decreased in individuals who have perfusion difficulties, such as those with pneumonia. Having the arterial blood gases redone to verify accuracy is negligent and dangerous; a falling PaO2 level is a serious indication of worsening pulmonary status and must be addressed immediately. Drawing another blood sample and waiting for results will take too long.

Prepare to intubate the client. This decrease in PaO2 indicates respiratory failure; it warrants immediate medical evaluation. Most facilities have a protocol to increase the oxygen flow rate to keep oxygen saturation greater than 92%. The client PaO2 of 65 mm Hg is not severe enough to intubate the client without first increasing flow rate to determine if the client improves. Decreasing the tension of oxygen in the plasma is inappropriate and will compound the problem. The PaO2 is a measure of the pressure (tension) of oxygen in the plasma; this level is decreased in individuals who have perfusion difficulties, such as those with pneumonia. Having the arterial blood gases redone to verify accuracy is negligent and dangerous; a falling PaO2 level is a serious indication of worsening pulmonary status and must be addressed immediately. Drawing another blood sample and waiting for results will take too long.

A client is being prepared for surgery to have placement of a percutaneous endoscopic gastrostomy (PEG) tube. The client asks why the PEG tube is preferred over the existing nasogastric tube that is being used for feedings. Which explanation would the nurse give?

There is less chance of aspiration