Oxygenation/Gas Exchange

After the nurse has finished teaching a client about sickle cell anemia, which statement indicates that the client has a correct understanding of the condition?

"I have abnormal hemoglobin."

Which amount is the normal value of a client's inspiratory reserve volume?

3.0 L

The nurse noticed the respiratory rate as regular and slow while assessing a client. Which would be the condition of the client?

Bradypnea

Which substance will the home care nurse instruct a client to use after laryngectomy to cleanse the stoma site?

Mild soap and water

Which is the optimal area for the nurse to assess adequate tissue oxygenation in an African-American neonate?

Mucous membranes of the mouth

A client takes morphine sulfate for severe metastatic bone pain. The nurse will assess the client for which adverse effect?

Respiratory depression

A client is hospitalized with a diagnosis of emphysema. The nurse provides teaching and would begin with which aspect of care?

The disease process and breathing exercises

Soft swishing sounds of breathing are heard when the nurse auscultates a client's chest. Which term would be used when documenting this assessment finding?

Vesicular breath sounds

Which nursing intervention has the highest priority for a client who was in a motor bike accident and has a severe neck injury?

Maintaining a patent airway

Which symptoms are common during the fulminant stage of inhalation of anthrax?

The fulminant stage of inhalation of anthrax is manifested by dyspnea, diaphoresis, and a high body temperature.

Which symptoms are common during the prodromal stage of inhalation of anthrax?

The prodromal stage of inhalation of anthrax is manifested by a dry cough and mild chest pain.

Which is the cause of frequent upper respiratory tract infections in toddlers?

Immature immune system

Which disease is caused by coronaviruses?

Severe acute respiratory syndrome

A client reports left-sided chest pain after playing racquetball. The client is hospitalized and diagnosed with left pneumothorax. When assessing the client's left chest area, the nurse expects to identify which finding?

Absence of breath sounds on auscultation

Which assessment finding of a client being treated in the emergency department after a motor vehicle collision indicates the need for immediate health care provider intervention?

Facial edema and septal deviation indicate that the client has sustained facial injuries. Clear nasal drainage is an indication of a cerebrospinal fluid leak, and the nurse would immediately report the finding and send the drainage to be tested for glucose. An oxygen level of 89% would be reported to the health care provider as it could indicate nonvisible injuries. "Raccoon eyes" or bilateral periorbital bruising indicates a basilar skull fracture and requires immediate medical treatment.

A client with a diagnosis of myocardial infarction asks the nurse, "What is causing the pain I am having?" Which explanation would the nurse give?

Inadequate oxygenation of the myocardium

A chronically ill, older client lives with their daughter. The client reports the daughter, who has three small children, seems run-down, coughs a lot, and sleeps all the time. Which statement supports the need for the nurse to pursue the daughter's condition as a potential case finding?

Older adults with chronic illness are more susceptible to tuberculosis.

Which clinical manifestations are associated with a diagnosis of tuberculosis?

Signs include a persistent cough, anorexia, hemoptysis, night sweats, shortness of breath, and a high body temperature.

Which assessment finding of a client with heart failure would prompt the nurse to contact the health care provider?

Signs of worsening heart failure include fatigue, weakness, and difficulty breathing when lying flat (orthopnea). Other manifestations include pitting edema, weight gain, and a dry, hacking cough.

Which nursing action has the highest priority when preparing to transfer an unconscious client who sustained a head injury from the emergency department to a neurological trauma unit?

Validating availability of a bag-valve-mask during the transfer