1262 Concepts Test 7

A nurse is reinforcing teaching with he parents of a child who has cystic fibrosis and a prescription for pancrelipase capsules. Which of the following instructions should the nurse include in the teaching? "Observe for signs of bleeding." "Discontinue the medication when the child's symptoms resolve." "Administer the medication with meals and snacks." "Tell your child to chew the capsules thoroughly."

"Administer the medication with meals and snacks." **The child should take pancrelipase with meals and snacks to promote digestion of fats, carbohydrates, and proteins.

A nurse is reinforcing teaching with the parents of a school-age child who has cystic fibrosis. Which of the following statements should the nurse make? "Bradycardia is an early indicator of a pneumothorax." "A pigeon-shaped chest might become evident as the disease progresses." "Engage the child in daily aerobic exercise." "Administer a bronchodilator to the child after chest percussion therapy."

"Engage the child in daily aerobic exercise." **Engaging the child in daily aerobic exercise stimulates mucous excretion, enhances self-esteem, and is recommended as a daily adjunct to chest percussion therapy.

The nurse is teaching the mother of a 5-year-old child who has cystic fibrosis about pancreatic enzymes. The nurse should understand that further teaching is necessary when the mother makes which of the following statements? "The enzymes probably won't cause many side effects." "The enzymes help him digest fat." "I will give my son the enzymes between meals." "I will put the enzyme crystals in his applesauce."

"I will give my son the enzymes between meals." **​The parent should give the child pancreatic enzymes with every meal and snack.

A nurse is reinforcing discharge instructions with a parent of a child who has cystic fibrosis. Which of the following statements by the parent indicates an understanding of the teaching? "I will make sure my child washes her hands before eating." "I will put my child in daycare to ensure that she socializes with other children." "I will provide low-fat meals for my child." "I will restrict the amount of salt in my child's meals."

"I will make sure my child washes her hands before eating." **Clients who have cystic fibrosis are at high risk for infection and should use good hand washing techniques before eating.

A nurse is reinforcing preoperative teaching with a client who is to undergo a pneumonectomy. The client states, "I am afraid it will hurt to cough after the surgery." Which of the following statements should the nurse make? "After the surgeon removes the lung, you will not need to cough." "I'll make sure you get a cough suppressant to keep you from straining the incision when you cough." "I will show you how to splint your incision while coughing." "Don't worry. You will have a pump that delivers pain medication as you need it, so you will have very little pain."

"I will show you how to splint your incision while coughing." *The client who had a pneumonectomy must cough to clear secretions from the remaining lung. The nurse should show the client how to splint her incision to reduce pain when coughing.

A nurse is assisting with discharge teaching for aliment who postoperative following a rhinoplasty. Which of the following instructions should the nurse include? "Take aspirin 650 milligrams by mouth for mild pain." "Close your mouth when sneezing." "Apply warm compresses to the face." "Lie on your back with your head elevated 30° when resting."

"Lie on your back with your head elevated 30° when resting." **The nurse should instruct the client to rest in the semi-Fowler's position to prevent aspiration of nasal secretions.

A nurse is reinforcing teaching with the mother of a child who has cystic fibrosis and is to take pancreatic enzymes three times per day. Which of the following statements indicates the mother understands the information? "My child will chew the capsules." "My child will take the enzymes 2 hours before meals." "My child will take the enzymes to help digest the fat in foods." "My child will take the enzymes to prevent nausea."

"My child will take the enzymes to help digest the fat in foods." **Pancreatic enzymes improve digestion of fats, carbohydrates, and protein.

A nurse is caring for a 2-week old infant whose mother requests additional information about sudden infant death syndrome (SIDS). Which of the following responses should the nurse make? "You should place your baby on her back when sleeping to decrease the risk of SIDS." "SIDS rates have been rising over the last 10 years." "SIDS is directly correlated to diphtheria, tetanus, and pertussis vaccines." "Sleep apnea is the main cause of SIDS."

"You should place your baby on her back when sleeping to decrease the risk of SIDS." **The nurse should reinforce to the mother that placing the baby on her back to sleep will reduce the risk of SIDS. The incidence of SIDS has declined since the Back to Sleep campaign started.

A nurse is reinforcing teaching about rifampin with a female client who has active tuberculosis. Which of the following statements should the nurse include in the teaching? "The medication causes amenorrhea if taken along with an oral contraceptive." "You should wear glasses instead of contacts while taking this medication." "A yellow tint to the skin is an expected reaction to the medication." "Lifelong treatment with this medication is necessary."

"You should wear glasses instead of contacts while taking this medication." **The nurse should reinforce that rifampin turns body fluids such as tears, sweat, saliva, and urine a reddish-orange color. The nurse should advise the client of possible permanent stains on clothing and soft contact lenses.

A nurse on a medical unit is assisting with care of a client who has a possible closed pneumothorax and significant bruising on the left chest following a motor-vehicle crash. The client reports sever left chest pain on inspiration. The nurse should hear which of the following findings when auscultating the client's lung sounds? Rhonchi Inspiratory stridor Absence of breath sounds Expiratory wheezing

Absence of breath sounds **A client who has pneumothorax experiences severely diminished or absent breath sounds on the affected side.

A health care professional is caring for a patient who is having difficulty mobilizing thick respiratory secretions. Which of the following drugs should the health care professional expect to administer? Azelastine (Astelin) Beclomethasone (Beconase AQ) Ipratropium (Atrovent) Acetylcysteine (Acetadote)

Acetylcysteine (Acetadote) **Acetylcysteine is a mucolytic that loosens thick respiratory secretions.

Legal restrictions apply to the purchase of pseudoephedrine (Sudafed) because which of the following risks? Rebound congestion Drug tolerance Respiratory depression Drug abuse

Drug abuse **Because it is possible to alter pseudoephedrine and epinephrine, the law restricts the drugs' purchase.

A nurse is assisting with the plan of care for client who has pneumonia and requires chest percussion, vibration, and postural drainage. Which of the following actions should the nurse plan to complete first? Auscultate lung fields. ​Cup hands and tap on the client's chest repeatedly. Provide mouth care. Position the client so that the lung area to be drained is above the client's trachea.

Auscultate lung fields. **The priority action the nurse should take when using the airway, breathing, circulation (ABC) approach to client care is to auscultate lung fields to determine which lung areas are most affected and would be the focus of the procedure.

A nurse is preparing to assist a provider to withdraw arterial blood from a client's radial artery for measurement of ABG. Which of the following actions should the nurse plan to take? Release pressure applied to the puncture site 1 min after the needle is withdrawn. Apply ice to the site after obtaining the specimen. Hyperventilate the client with 100% oxygen prior to obtaining the specimen. Check the circulation in the client's ulnar artery prior to obtaining the specimen.

Check the circulation in the client's ulnar artery prior to obtaining the specimen. **The nurse should ensure that circulation to the hand is adequate from the ulnar artery in case the radial artery is injured from the blood draw. The most common site for withdrawal of arterial blood gases is the radial artery.

A heath care professional should recognize that using pseudoephedrine (Sudafed) to treat allergic rhinitis requires cautious use with he patients who have which of the following? Peptic ulcer disease A seizure disorder Anemia Coronary artery disease

Coronary artery disease *Because pseudoephedrine, an oral sympathomimetic, can cause systemic vasoconstriction, it requires cautious use with patients who have severe hypertension or coronary artery disease.

A health care professional should tell a patient who is taking albuterol (Proventil) to report which of the following possible indications of a serious adverse effect? Polyuria Bruising Fever Palpitations

Palpitations *Beta2 agonists can cause cardiac stimulation, resulting in chest pain, tachycardia, and hypertension. This is rare with short-acting beta2 agonists, but it is possible.

A nurse in an urgent care clinic is collecting data from a client who reports exposure to anthrax. Which of the following findings is an indication of the prodromal stage of inhalation anthrax? Dry cough Swollen lymph nodes Sore throat Rhinitis

Dry cough **The client who has a dry cough has a clinical manifestation found in the prodromal stage of inhalation anthrax. During this stage, it is difficult to distinguish from influenza or pneumonia because there is no sore throat or rhinitis.

A nurse is assisting with he plan of care for a client who has chronic obstructive pulmonary disease and is malnourished. Which of the following recommendations to promote nutritional intake should the nurse include in the plan? Perform active range-of-motion exercises before meals. Increase intake of water at meal times. Eat high-calorie foods first. Keep saltine crackers nearby for snacking.

Eat high-calorie foods first **The client who has COPD often experiences early satiety. Therefore, the client should eat calorie-dense foods first.

A nurse is reinforcing teaching about pursed-lip breathing for a client who has chronic obstructive pulmonary disease and emphysema. The nurse should explain that this breathing technique does which of the following? Increases oxygen intake Keeps the airways open on exhalation Strengthens the diaphragm Uses the intercostal muscles

Keeps the airways open on exhalation **The client who has COPD with emphysema should use pursed-lip breathing when experiencing dyspnea. This is one of the simplest ways to control dyspnea. It slows the client's pace of breathing and keeps the airway open on exhalation, making each breath more effective. Pursed-lip breathing releases trapped air in the lungs and prolongs exhalation to slow the breathing rate. This improved breathing pattern moves carbon dioxide out of the lungs more efficiently.

A nurse in a provider's office is collecting data from a client who states he was recently exposed to tuberculosis. Which of the following findings is a clinical manifestation of pulmonary tuberculosis? Night sweats Cyanosis of the fingertips Weight gain Pericardial friction rub

Night sweats **Night sweats and fevers are clinical manifestations of tuberculosis.

A nurse is caring for a client who has pneumonia. The client's oxygen saturation is 85%. Which of the following actions should the nurse take first? Encourage the client to cough and deep breathe. Raise the head of the bed. Initiate humidification therapy. Increase the client's oral fluid intake.

Raise the head of the bed. **According to evidenced-based practice, the nurse should first elevate the head of the bed ton reduce the client's workload and minimize fatigue. It uses gravity to drop the abdominal organs away from the diaphragm, which allows optimal expansion of the lungs.

A health care professional is advising a patient about the use of cromolyn sodium to prevent bronchospasm. The health care professional should explain that the drug prevents bronchospasm because it performs which of the following actions? Causes bronchodilation Blocks muscarinic receptors Increases leukocyte activity Reduces inflammation

Reduces inflammation *Cromolyn sodium, a mast cell stabilizer, reduces inflammation by inhibiting the inflammatory response.

A nurse is assisting the provider to prepare a client for a thoracentesis. The nurse should instruct the client that which of the following positions will be used for this procedure? Prone with the arms raised over the head Supine with the head of the bed elevated Lying flat on the affected side Sitting while leaning forward over the bedside table

Sitting while leaning forward over the bedside table **When preparing a client for a thoracentesis, the nurse should have the client sit on the edge of the bed and lean forward over the bedside table because this position maximizes the space between the client's ribs and allows for aspiration of accumulated fluid and air.

A nurse on a medical-surgical unit is caring for a client who is postoperative following hip replacement surgery. The client reports feeling apprehensive and restless. The nurse collects additional data from the client. Which of the following findings is an indication of pulmonary embolism? Bradycardia Sudden onset of dyspnea Difficulty swallowing Tracheal deviation

Sudden onset of dyspnea **Clinical manifestations of pulmonary embolism have a rapid onset. Dyspnea occurs due to reduced blood flow to the lungs.

A nurse is caring for a client who has a tracheostomy with an inflated cuff in place. Which of the following findings indications that the nurse should suction the client's airway secretions? The client's airway secretions were last suctioned 2 hr ago. The client is unable to speak. The client has coarse crackles in the lung fields. The client coughs and expectorates a large mucous plug.

The client has coarse crackles in the lung fields. **The nurse should auscultate coarse crackles or rhonchi, identify a moist cough, hear or see secretions in the tracheostomy tube, and then suction the client's airway secretions.

A nurse is assisting with planning an immunization clinic for older adult clients. Which of the following information should the nurse plan to include about influenza? The influenza vaccine is necessary only for clients who have never had influenza. Immunization for influenza should be repeated every 10 years. Individuals at high risk should receive the live influenza vaccine. The composition of the influenza vaccine changes yearly.

The composition of the influenza vaccine changes yearly. **Influenza outbreaks occur annually and the prevalent influenza viruses change yearly. Consequently, the previous year's influenza immunization will not protect a client exposed to the current year's influenza strains.

A health care professional who is advising a patient about he use of mucolytic to treat a cough should explain that his type of drug is effective because is performs which of the following actions? Reduces inflammation Suppresses the cough stimulus Dries secretions Thins and loosens mucus

Thins and loosens mucus *Mucolytics make mucus less viscous to increase a cough's productivity.

When explaining how a patient should use ipratropium (Atrovent), a health care professional should include which of the following instructions? Check pulse rate after inhaling the drug. This drug is used to thin respiratory secretions. Do not drink anything for 30 min after using the drug. Wait 5 min between using the drug and another inhaled drug.

Wait 5 min between using the drug and another inhaled drug **Ipratropium, an inhaled anticholinergic, requires a 5-min wait between its administration and that of another inhaled drug to allow for its bronchodilating effects.

A health care professional should explain to a patient who is prescribed diphenhydramine that the most common side effect associated with the drug is muscle tremors. anxiety. sedation. insomnia.

sedation. **The most common adverse effect of diphenhydramine, a first-generation antihistamine, is sedation.

A nurse is assisting with the admission of a client who has tuberculosis with a productive cough. Which type of isolation precautions should the nurse initiate for the client? ​Contact ​Droplet ​Protective ​Airborne

​Airborne **The nurse should initiate airborne precautions when a client has an infection that spreads through small droplets that remain airborne for longer periods, such as tuberculosis and measles. The client requires a negative pressure airflow room, and staff should wear an N95 respirator when in contact with the client.

A nurse is reinforcing teaching with new parents about risk factors for sudden infant death syndrome (SIDS). Which of the following statements by a parent indicates an understanding of the teaching? "I do not plan to offer my baby a pacifier during naps or at bedtime." "My baby will be placed on her back when sleeping." "Our baby will sleep in my bed because I am breastfeeding." "We will place an antique quilt in our baby's crib."

"Our baby will sleep in my bed because I am breastfeeding." **Cosleeping, or sharing a bed with an adult or older child, is associated with SIDS. The infant's crib can be placed in close proximity to the parent's bed. The infant should be returned to the crib once breastfeeding is completed.

An assistive personnel (AP) asks a nurse what precautions he should take when measuring the vital signs of a client who has pneumonia. which of the following responses should the nurse make? "Gloves are not necessary if you wash your hands well." "Wear a gown whenever you come in close contact with the client." "Wear a mask when entering the client's room." "Place a mask on the client when you check her vital signs."

"Wear a mask when entering the client's room." **Since a client who has pneumonia requires droplet precautions, it is necessary for the AP to wear a mask while caring for this client.

A nurse in a clinic is reinforcing teaching with a client who is to have a tuberculin skin test. Which of the following information should the nurse include? "If the test is positive, it means you have an active case of tuberculosis." "If the test is positive, you should have another tuberculin skin test in 3 weeks." "You must return to the clinic to have the test read in 2 or 3 days." "A nurse will use a small lancet to scratch the skin of your forearm before applying the tuberculin substance."

"You must return to the clinic to have the test read in 2 or 3 days." **The client should have the skin test read in 2 to 3 days. An area of induration after 48 to 72 hr indicates exposure to the tubercle bacillus. If the client does not return to have the test read within 72 hr, another skin test is necessary.

A health care professional is talking to a patient who is prescribed albuterol (Proventil) via inhaler and fluticasone (affair) via inhaler for asthma management. The health care professional should tell the patient to use the albuterol inhaler before using the fluticasone inhaler for which of the following reasons? Albuterol will decrease inflammation. Fluticasone will reduce the adverse effects of albuterol. Albuterol will increase the absorption of fluticasone. Albuterol will reduce nasal secretions.

Albuterol will increase the absorption of fluticasone. **Albuterol, an inhaled, short-acting beta2 agonist, causes bronchodilation, which will increase the absorption of fluticasone, an inhaled glucocorticoid, when the patient uses it before the glucocorticoid.

A health care professional who is advising a patient about using intranasal glucocorticoids should include which of the following instructions? Allow at least 2 weeks for the full therapeutic effect. Take the drug as needed for nasal congestion. Start at a low dose and gradually increase it. Use the drug prior to exercise.

Allow at least 2 weeks for the full therapeutic effect. **It can take 2 or 3 weeks to see the full effect from intranasal glucocorticoids.

When advising a patient about taking prednisone for chronic asthma, a health care professional should include which of the following information? Rinse your mouth after taking the drug to prevent a yeast infection. Change position slowly when standing up. Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs). Stop taking the drug if you become nauseated.

Avoid taking nonsteroidal anti-inflammatory drugs (NSAIDs). **Gastric protective measures are essential for patients who are taking oral glucocorticoids. Anti-inflammatory drugs can cause GI bleeding, so patients should not take them concurrently with prednisone.

A nurse is caring for a client who has pneumonia and has been receiving oxygen therapy for several days. When collecting data from a client, the nurse should identify which of the following findings as an indication of an adverse effect of oxygen therapy? Cracks in oral mucous membranes ​Poor skin turgor ​Excessive pulmonary secretions ​Tachycardia

Cracks in oral mucous membranes **Oxygen therapy, especially when long-term or without sufficient humidification, is extremely drying to the nasal and oral mucosa and can cause cracks.

A nurse is assisting with the care of a client who had a chest tube inserted 12 hr ago. The nurse notes a crackling sensation upon palpitation of the skin on the right side of the client's chest. The nurse should notify the charge nurse that the client is demonstrating clinical manifestation of which of the following complications? Tactile fremitus Friction rub Crackles Crepitus

Crepitus **Crepitus, also called subcutaneous emphysema, is a coarse crackling sensation that the nurse can feel when palpating the skin surface over the client's chest. Crepitus indicates an air leak into the subcutaneous tissue, which is often a clinical manifestation of a pneumothorax.

A nurse is collecting data from a client who has pneumonia and is experiencing acute respiratory acidosis. Which of the following manifestations should the nurse expect to find? Muscle flaccidity Cool, clammy skin Decreased level of consciousness Circumoral numbness and tingling

Decreased level of consciousness **The nurse should expect to find a decreased level of consciousness in a client who is experiencing respiratory acidosis. The rise in carbon dioxide dilates the cerebral vessels causing a feeling of fullness in the head, leading to mental cloudiness and a decreased level of consciousness.

A nurse is reinforcing teaching with a client who has cystic fibrosis and is receiving pancrelipase. The nurse should teach the client that which of the following is an effect of this medication? Increased nasal congestion Decrease viscosity of sputum Decreased fat in stools Increased appetite

Decreased fat in stools **Clients who have cystic fibrosis supplement meals with oral pancreatic enzymes to reduce the fat content in their stools. Clients receiving pancreatic enzymes as a digestive aid should expect to have a reduction of fat in their stools.

A health care professional is advising a patient about the use of beclomethasone (Beconase AQ) to treat asthma. The health care professional should explain that the drug treats asthma because it performs which of the following actions? Relaxes bronchial smooth muscle Increases cough threshold Decreases inflammation Thins mucus

Decreases inflammation *Beclomethasone, an intranasal glucocorticoid, treats asthma by reducing inflammation.

A nurse is assisting with he development of a teaching plan about how to prevent an acute asthma attack for a young adult client. Which of the following points should the nurse plan to discuss first? Discuss with the client about the client's medication regimen. Talk about how to eliminate environmental triggers that precipitate attack. Determine the client's perception of the disease process and what might have triggered the current attack. Review the manifestations of respiratory infections.

Determine the client's perception of the disease process and what might have triggered the current attack. **The nurse should apply the nursing process priority-setting framework. The nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing process builds on the previous step, beginning with assessment or data collection. Before the nurse can formulate a plan of action, implement a nursing intervention, or notify a provider of a change in the client's status, she must first collect adequate data from the client. Assessing or collecting additional data will provide the nurse with knowledge to make an appropriate decision. Therefore, the first step the nurse should take is to assess the client's current knowledge.

A nurse is assisting with he admission of a client who has meningococcal pneumonia. Which of the following isolation precautions should the nurse initiate? Droplet Airborne Contact Protective

Droplet **The nurse should initiate droplet precautions for a client who has an infection she can transmit by droplets larger than 5 microns and when within 3 feet of the client, such as meningococcal pneumonia, diphtheria, rubella, pertussis, and mumps.

A nurse is contributing to the care plan of an older adult client who has pneumonia. Which of the following interventions should the nurse include in the plan? Assist the client to cough and deep breathe every 4 hr. Encourage independence in completing ADLs. Encourage fluid intake of 2.5 L per day. Use an N-95 respirator when providing client care.

Encourage fluid intake of 2.5 L per day. **Increasing fluid intake for the client who has pneumonia will assist in breaking up the consolidation in the lungs by thinning the mucous, allowing the client to cough more effectively.

A nurse is caring for a client who has pneumonia and is coughing up secretions. Which of the following actions should the nurse take first? Provide chest percussion on the client. Obtain the client's temperature. Encourage the client to cough and deep breathe. Encourage the client to increase oral fluids.

Encourage the client to cough and deep breathe. **When using the airway, breathing, circulation approach to client care, the nurse should place the priority on the client's airway. Therefore, the nurse should encourage the client to cough and deep breathe to clear secretions.

A nurse is caring for a client who has pneumonia. Which of the following actions should the nurse take to thin the client's respiratory secretions? Encourage regular use of the incentive spirometer. Encourage the client to drink more fluids. Encourage the client to ambulate more often. Encourage coughing and deep breathing.

Encourage the client to drink more fluids. **Fluids help liquefy and thin pulmonary secretions, which facilitates expectoration to clear the airways. The client should drink 1,500 to 2,500 mL/day to keep secretions thin.

A health care professional is advising a patient about the use of cromolyn sodium. Which of the following instructions should the health care professional include? Anticipate difficulty sleeping. Expect a bitter aftertaste. Report signs of jaundice. Increase calcium and vitamin D intake.

Expect a bitter aftertaste. *Cromolyn sodium, a mast cell stabilizer, leaves a bitter aftertaste. Taking sips of water or sucking on hard candy after use of the drug can minimize this effect.

A nurse is collecting data from a client who has pulmonary tuberculosis. Which of the following findings should the nurse expect? Increased appetite High fever in the early morning ​Edema Fatigue

Fatigue **The nurse should expect a client who has pulmonary tuberculosis to report fatigue, night sweats, and a productive cough.

When advising a patient about using zileuton (Zyflo), a health care professional should include which of the following instructions? Have laboratory tests performed at regular intervals. Take the drug prior to exercising. Check the apical pulse before taking the drug. Rinse the mouth after using the drug.

Have laboratory tests performed at regular intervals. **Zileuton, a leukotriene modifier, can cause liver injury. The health care professional should monitor liver function once a month for 3 months, then every 2 to 3 months during the first year of treatment.

When advising a patient who is beginning fluticasone propionate/salmeterol (Advair) therapy, which of the following instructions should a health care professional include? Take the drug as needed for acute asthma. Increase weight-bearing activity. Follow a low-sodium diet. Use an alternate-day dosing schedule.

Increase weight-bearing activity. *Weight-bearing activity can help minimize bone loss, which is a side effect of fluticasone propionate/salmeterol, an inhaled glucocorticoid.

A nurse on a medical unit is assisting with the care of client who aspirated gastric contents prior to admission. The provider prescribed 100% oxygen by nonrebreather mask after the client reported severe dyspnea. Which of the following findings is a clinical manifestation of acute respiratory distress syndrome (ARDS)? PaO2 50 mm Hg Rhonchi Tympanic temperature 38° C (100.4° F) Hypopnea

PaO2 50 mm Hg **The client who has manifestations of ARDS has a low PaO2 level even with the administration of oxygen. Hypoxemia after treatment with oxygen is a manifestation of ARDS.

A nurse is caring for a client who has active pulmonary tuberculosis (TB) and a prescription for a chest x-ray. Which of the following actions should the nurse plan to take? Have the transport personnel wear an N-95 mask when taking the client to radiology. Contact the provider to prescribe a different test. Place a surgical mask on the client prior to exiting the room. Cover a wheelchair with a sterile drape for the client to sit on.

Place a surgical mask on the client prior to exiting the room. **Clients who have TB can infect others because the bacteria travel into the air through normal respiration or by cough. Therefore, to protect others from harm the nurse should place a surgical mask on the client anytime the client is preparing to exit his room.

A nurse is assisting with planning interventions for an influenza outbreak in a long term care facility. Which of the following interventions should the nurse include in the plan? Implement airborne precautions for clients who have influenza. Assign health care personnel to nondirect care activities for 24 hr after developing influenza symptoms. Provide prophylactic antibiotics for clients who have been exposed to influenza. Place restrictions on visitation.

Place restrictions on visitation. ** During an influenza outbreak, individuals who are ill should not visit the clients in a long term care facility.

A nurse is caring for a client who is suspected to have active laryngeal tuberculosis (TB). Which of the following actions should the nurse plan to take to safely care for this client? Place the client in a private room with a special ventilation system. Move the client to a semi-private room with a client who requires droplet precautions. Have staff and visitors wear gowns while in the client's room. Remove personal protective equipment in the hallway outside of the client's room.

Place the client in a private room with a special ventilation system. **Clients suspected to have active laryngeal tuberculosis are placed in private rooms with negative-pressure airflow via HEPA filtration systems. Negative pressure pulls air away from the hallway and exhausts it out of the room to areas away from the intake vents.

A nurse is reviewing the medical record of a client who has pneumonia The nurse should plan to have the client lie on his stomach in the Trendelenburg position with pillows elevating the right side of his chest to mobilize secretions from which of the following lung segments? ​Posterior segment of the right lower lobe ​Anterior segment of the right middle lobe ​Posterior segment of the right middle lobe ​Anterior segment of the right upper lobe

Posterior segment of the right lower lobe **The nurse should have the client lie prone to drain secretions from the back portion of the lungs, and place the head lower than feet to create a downward flow of lower lobe secretions. Placing the right chest higher than the left drains the right lung fields. The nurse should use postural drainage 2 to 3 times daily, before meals, and provide treatments to loosen bronchial secretions first, as prescribed.

Before prescribing dextromethorphan (Robitussin) to a patient, the primary care provider should know that, when given with an opioid, the drug can result in which of the following? Increased renal reabsorption of the dextromethorphan Delayed analgesic effect of the opioid Potentiation of the analgesic effect of the opioid Reduced antitussive effect of dextromethorphan

Potentiation of the analgesic effect of the opioid *Combining dextromethorphan with an opioid, such as morphine, increases the analgesic effect of the opioid.

A health care professional who is advising a patient about the use of antihistamines to treat allergic rhinitis should explain that these drugs are effective because they perform which of the following actions? Reduces nasal congestion Blocks H2 receptors Prevents histamine from binding to receptors Decreases viscosity of nasal secretions

Prevents histamine from binding to receptors **Antihistamines treat allergic rhinitis and reduce swelling by blocking histamine from binding to the receptor sites.

A health care professional who is advising a patient about he use of expectorant to treat a cough should explain that this type of drug is effective because if performs which of the following actions? Dries mucous membranes Reduces inflammation Reduces surface tension Suppresses the cough stimulus

Reduces surface tension *Expectorants act by reducing the surface tension of respiratory secretions. This results in thinning thick mucus, making it easier to cough out of the lungs and drain out of the nose and sinuses.

A health care professional is caring for a patient who is taking codeine. Which of the following is the most important assessment following administration of the drug? Blood pressure Apical heart rate Respirations Level of consciousness

Respirations **The greatest risk to patients who are taking codeine, an opioid agonist, is severe respiratory depression. Therefore, the most important assessment is the respiratory rate.

A nurse is caring for an older client who has chronic obstructive pulmonary disease and pneumonia. The nurse should monitor the client for which of the following acid-base imbalances? Metabolic alkalosis Respiratory acidosis Respiratory alkalosis Metabolic acidosis

Respiratory acidosis **Respiratory acidosis is a common complication of COPD. This complication occurs because clients who have COPD are unable to exhale carbon dioxide due to a loss of elastic recoil in the lungs.

A health care professional is advising a patient about he adverse effects of pseudophedrine (Sudafed). Which of the following should the health care professional include? (select all that apply) Anxiety Insomnia Bradycardia Muscle pain Restlessness

Restlessness Anxiety Insomnia **Restlessness is correct. Restlessness is an adverse effect of pseudoephedrine, an oral sympathomimetic. Insomnia is correct. Insomnia is an adverse effect of pseudoephedrine. Anxiety is correct. Anxiety is an adverse effect of pseudoephedrine.

A health care professional is monitoring plasma drug levels in a patient who is taking theophylline (Theo-24). Which of the following adverse effects should the health care professional expect to see if the patient's level indicates toxicity? Restlessness Seizures Vomiting Constipation

Seizures **Seizures are likely when plasma drug levels of theophylline, a methylxanthine, are higher than 30 mcg/mL, which indicates toxicity.

A nurse is reinforcing teaching about diagnostic tests with the parents of a child who has suspected cystic fibrosis. Which of the following diagnostic tests should the nurse include as the most definitive when diagnosing cystic fibrosis? Sputum culture Sweat chloride test Pulmonary function test Stool fat content analysis

Sweat chloride test **Clients who have cystic fibrosis have an increase of sodium and chloride in both saliva and sweat. Therefore, a sweat chloride test is a definitive diagnostic test for determining a diagnosis of cystic fibrosis.

Which of the following should a health care professional include when advising a patient about the use of motelukast (Singulair?) Rinse the mouth to prevent an oral fungal infection. Take the drug at the onset of bronchospasm. Take the drug once a day in the evening. Use a spacer to improve inhalation.

Take the drug once a day in the evening. **Montelukast, a leukotriene modifier, is most effective when taken once per day in the evening.

A nurse is assisting with the plan of care for a client following placement of a chest tube 1 hr ago. Which of the following actions should the nurse include in the plan of care? Empty the collection chamber and record the amount of drainage every 8 hr. Clamp the chest tube if there is continuous bubbling in the water seal chamber. Keep the chest tube drainage system at the level of the right atrium. Tape all connections between the chest tube and drainage system.

Tape all connections between the chest tube and drainage system. **The nurse should tape all connections to ensure that the system is airtight and prevent the chest tubing from accidently disconnecting.

A nurse is collecting data from a client who has a prescription for cisplatin IV to treat lung cancer. Which of the following client findings is an adverse effect of this medication? Hallucinations Tinnitus Hand and foot syndrome Pruritus

Tinnitus **An adverse effect of cisplatin is ototoxicity, which can cause tinnitus.

A nurse is reinforcing teaching with a client who has cystic fibrosis and a prescription for daily chest physiotherapy The nurse should instruct the client that which of the following is the purpose of these treatments? To stimulate the cough reflex To encourage deep breaths To mobilize secretions in the airways To dilate the bronchioles

To mobilize secretions in the airways **The purpose of chest physiotherapy is to loosen the client's secretions and promote drainage of secretions from the lungs. Chest physiotherapy includes percussion, vibration, and promotion of drainage by gravity.

A nurse is reinforcing teaching with a client about pulmonary function tests. Which of them following tests measures the volume of air the lungs can hold at the end of maximum inhalation? Vital lung capacity Residual volume Total lung capacity Functional residual capacity

Total lung capacity **Pulmonary function tests are used to examine the effectiveness of the lungs and identify lung problems. Total lung capacity measures the amount of air the lungs can hold after maximum inhalation.

A nurse is caring for a client who comes to the clinic to be tested with tuberculosis (TB) after a close family contact tests positive. Which of the following measures should the nurse anticipate preparing for this client? Bacille Calmette-Guérin (bCG) vaccine Sputum culture for acid fast bacillus (AFB) Tuberculin skin test Chest x-ray

Tuberculin skin test **The nurse should anticipate preparing the client to receive the tuberculin skin test (TST). The TST is an accurate screening tool for the presence of tuberculosis in an individual; however, it does not distinguish between previous exposure and active illness. The TBT requires multiple visits to the clinic, one to receive the injection and another visit, 48-72 hours later, to have the test read by a qualified health professional.

A nurse is assisting with he care of school-age child who has respiratory failure due to pneumonia. Which of the following positions should the nurse encourage to allow maximal lung expansion? Prone Supine Side-lying Upright

Upright Optimal positioning for allowing maximal lung expansion and comfort in children who have respiratory insufficiency or failure is sitting upright or leaning forward.

A health care professional is caring for a patient who is taking ipratropium (atrovent). The health care professional should explain which of the following adverse effects to the patient? Urinary retention Insomnia Tachycardia Dry mouth Muscle tremors

Urinary retention Dry mouth **Urinary retention is correct. Urinary retention can occur with ipratropium, an inhaled anticholinergic. Dry mouth is correct. Ipratropium can dry the oral secretions.

A nurse is reinforcing discharge teaching with a client who has pulmonary tuberculosis and is to start taking rifampin. Which of the following information should the nurse include? Urine and other secretions will turn orange. Take the medication with meals. Purified protein derivative skin test results will improve in 3 months. Expect to have insomnia while taking this medication.

Urine and other secretions will turn orange. **Rifampin will turn the urine and other secretions a harmless reddish-orange color. This includes sputum, tears, and sweat.

A nurse is caring for a client who was placed on isolation precautions for active pulmonary tuberculosis (TB). Which of the following actions should the nurse plan to take? (select all that apply) Remind the client to cover her mouth with a tissue when coughing. Instruct the client about taking antifungal medications. Place the client in a room with positive airflow. Determine whether the client lives alone or with others. Use an alcohol-based hand cleaner unless hands are visibly soiled.

Use an alcohol-based hand cleaner unless hands are visibly soiled. Remind the client to cover her mouth with a tissue when coughing. Determine whether the client lives alone or with others. **Use an alcohol-based hand cleaner unless hands are visibly soiled is correct. The nurse should plan to use an alcohol-based hand cleaner after client care tasks when caring for a client who has TB. The nurse should wash her hands with soap and water after performing care for any client in which the hands become visibly contaminated. Remind the client to cover her mouth with a tissue when coughing is correct. The nurse should remind the client to cover her mouth with a tissue when coughing to minimize contamination of the air in the client's room. Determine whether the client lives alone or with others is correct. The nurse should determine any close contacts the client has and recommend that those individuals undergo Mantoux testing. Place the client in a room with positive airflow is incorrect. The nurse should plan to place the client in a room with negative airflow to prevent air contaminated with TB from entering the hallways. Instruct the client about taking antifungal medications is incorrect. The nurse should instruct the client about taking antibiotic medications to treat TB.

A nurse is preparing to review discharge instructions with a client who has pulmonary tuberculosis. Which of the following information should the nurse include? Consume alcohol in moderation while taking antituberculosis medications. Place tissue soiled with respiratory secretions in a paper bag for later disposal. Provide samples for sputum cultures every 6 weeks. Wear a mask while out or around crowds of people.

Wear a mask while out or around crowds of people. **The nurse should inform the client to wear a mask until the medication has suppressed the infection, which is determined by three consecutive negative sputum cultures.

A healthcare professional cautions a patient who is taking guaifenesin (Mucinex) about using combination over-the-counter cold products because rebound congestion is likely. serious interactions are possible. drug tolerance is likely. they can also contain guaifenesin.

they can also contain guaifenesin. *Many combination over-the-counter cold products contain guaifenesin; a patient taking both might be taking excessive amounts of the drug. Combination products also contain multiple drugs to treat different manifestations, all of which might not be present. Virtually all drugs have potential adverse effects so the patient should use only those drugs required to treat existing symptoms and only in the recommended amounts.

A nurse is performing pulmonary hygiene for a client who has pneumonia. The nurse should have the client lie on his back with his head elevated to mobilize secretions from which of the following lung segments? ​Anterior segment of the right middle lobe ​Anterior segment of the right upper lobe ​Posterior segment of the right middle lobe ​Posterior segment of the right lower lobe

​Anterior segment of the right upper lobe **The nurse should place the client supine (on the back) to promote drainage from the anterior portion of the lung, and elevate the client's head to promote flow of draining downward from the right upper lobe. The nurse should use postural drainage 2 to 3 times daily, before meals, and provide treatments to loosen bronchial secretions first, as prescribed.

A nurse is reviewing the medical record for a client who has pneumonia. The nurse should plan to have the client lie on his back with his head lower than his feet to mobilize secretions from which of the following lung segments? ​Posterior segments of both lower lobes ​Apical segments ​Both upper lobes ​Anterior segments of both lower lobes

​Anterior segments of both lower lobes **The nurse should have the client lay supine (on the back) to promote flow of secretions from the front part of the lungs, and use Trendelenburg position (head lower than feet) to drain lower lobes.

A nurse is caring for a client who has pneumonia. The nurse should place the client on his right side in Trendelenburg position to help mobilize secretions from which of the following lung segments? ​Posterior segment of the left upper lobe ​Lateral segment of the right lower lobe ​Posterior segment of the right lower lobe ​Lateral segment of the left lower lobe

​Lateral segment of the left lower lobe **The nurse should place the client on the right side to drain the left lung, and use Trendelenburg position (head lower than feet) to promote downward drainage of secretions from the lower lobe segment. The nurse should use postural drainage 2 to 3 times daily, before meals, and provide treatments to loosen bronchial secretions first, as prescribed.

A nurse is caring for a client who has tuberculosis and is about to start taking pyrazinamide. The nurse should identify that the client needs which of the following tests while taking his medication therapy? ​Thyroid function studies ​Blood glucose levels ​Liver function tests ​Gallbladder studies

​Liver function tests **The nurse should identify that pyrazinamide can cause hepatotoxicity; therefore, the provider should monitor the client's liver function regularly while taking this medication.

A nurse is assisting in the plan of care for a client who has pneumonia. Which of the following nursing actions should be included? Position the client prone. Cough and deep breathe every 4 hr. ​Encourage fluid intake of 1500 mL/day. ​Obtain a sputum culture.

​Obtain a sputum culture. **The nurse should obtain a sputum culture to determine which antibiotic is needed for the organism that is causing the pneumonia.

for which of the following reasons shoulda patient attach a spacer to a metered-dose inhaler? To increase the speed of drug delivery To increase the amount of drug delivered to the oropharynx To increase the amount of drug delivered on exhalation ​To increase the amount of drug delivered to the lungs

​To increase the amount of drug delivered to the lungs **A spacer increases the amount of drug that reaches the lungs.