The nurse teaches a patient how to use an incentive
spirometer. What patient outcome will support the conclusion that the use of
the incentive spirometer was effective?
C.
A nurse is applying a warm compress. What should the nurse
explain to the patient is the primary reason why heat is used instead of cold?
C.
A practitioner orders chest physiotherapy with percussion
and vibration for a newly admitted patient. Which information obtained by the nurse
during the health history should alert the nurse to question the practitioner’s
order?
A.
A nurse teaches a patient about pursed-lip breathing. The
nurse identifies that the teaching is effective when the patient says its
purpose is to:
D.
What should the nurse do first if a patient is choking on
food?
A.
A patient has thick tenacious respiratory secretions. What
should the nurse do to best help liquefy the patient’s respiratory secretions?
B.
Which action is most effective in meeting the needs of a
patient experiencing laryngospasm after extubation?
D.
A patient’s hemoglobin saturation via pulse oximetry
indicates inadequate oxygenation. What should the nurse do first?
C.
A nurse is reviewing the laboratory results of a patient with
the preliminary diagnosis of anemia. Which diagnostic test reflects a response
to iron deficiency anemia?
C.
A nurse in the operative suite is preparing an older adult
for surgery. Which physiological factor places the older adult at the greatest
risk during surgery?
A.
A patient is admitted with the diagnosis of lower extremity
arterial disease (LEAD). Which is a specific desirable outcome for a patient
with this diagnosis?
D.
A practitioner orders bed rest for a patient. What should
the nurse explain to the patient is the primary purpose of bed rest?
D.
A nurse is planning to teach one patient pursed-lip
breathing and another patient diaphragmatic breathing. What technique
associated with diaphragmatic breathing is different form pursed-lip breathing
that the nurse should include in the teaching plan?
B.
A meal tray arrives for a patient who is receiving 24%
oxygen via a Venturi mask. What should the nurse do to meet this patient’s
needs?
A.
Which nursing assessment best indicates a patient’s ability
to tolerate activity?
D.
A nurse is caring for a patient who has a chest tube after
thoracic surgery. What should the nurse do when caring for this patient?
C.
A nurse is concerned about the risk for thrombophlebitis when
caring for a patient with impaired mobility. For which clinical manifestation
associated with thrombophlebitis should the nurse monitor the patient?
C.
An unconscious patient who had oral surgery is admitted to
the postaesthesia care unit. In which position should the nurse place the
patient?
C.
A practitioner orders chest physiotherapy with percussion
and vibration for a patient. After the practitioner leaves, the patient says, “I
still don’t understand the purpose of this therapy. The nurse’s best reply is, “It:
B.
The nurse raises the head of the bed for a patient who has
difficulty breathing. Which science includes the principle that explains how
this intervention facilitates respiration?
C.
Which clinical manifestation is of most concern when the
nurse assesses a patient who has impaired mobility?
D.
A nurse teaches a patient to make a series of short,
forceful exhalations just before actually coughing (huffing). What is the
purpose of this action?
expectorated
C.
Which are the most effective leg exercises the nurse should
encourage a patient to perform to prevent circulatory complications during the
postoperative period?
D.
Which outcome best reflects achievement of the goal, “The
patient will expectorate lung secretions with no sign of respiratory
complications”?
and 11 PM
D.
What should the nurse do first when caring for a nonverbal
patient who is restless, agitated, and irritable?
D.
A nurse is caring for a patient recieivng oxygen via a nasal
cannula. What should the nurse do?
D.
What is the most important thing the nurse should do to increase both the respiratory and the circulatory function of a patient in a coma?
C.
A patient sucking on a hard candy inhales while laughing and develops a total airway obstruction. What is the nurse attempting to do when implementing an abdominal thrust?
B.
A nurse is assessing a patient with a respiratory problem. Which clinical manifestation is most reflective of an early response to hypoxia?
B.
A nurse in the postanesthesia care unit is monitoring several patients who received general anesthesia. Which patient response causes the most concern?
D.
The practitioner orders oxygen for a patient be delivered at a high flow rate. Which additional nursing action is necessary when implementing a high-liter flow as opposed to a low liter flow?
A.
A nurse is teaching a patient how to use an incentive spirometer. Which position should the nurse insist the patient to assume during this procedure?
A.
Which is the most important action by the nurse after a patient has a thoracotomy?
D.
A nurse is assessing a postoperative patient. Which complication has most likely occurred when the patient experiences purulent sputum, dyspnea, and chest pain?
D.
An obese patient has limited mobility after an open reduction and internal fixation of a fractured hip. For which serious complication of increased blood coagulability should the nurse monitor the patient?
B.
A nurse is assessing a patient. Which clinical manifestation indicates respiratory distress?
D.
The nurse identifies that a patient's hands are edematous when attempting to apply a pulse oximetry probe. What is the nurse's priority action?
B.
The practitioner' order reads, "6 L Oxygen Via Face Mask." The patient, who has been extremely confused since being in the unfamiliar environment of the hospital, becomes agitates and repeatedly pulls of the mask. What should the nurse do?
A.
A nurse is caring for a male patient. Which laboratory results place this patient at risk for an impaired ability to tolerate activity?
A. Hct of 45%
B. Hgb of 14 g/dL
C. O2 saturation of 90%
D. RBC count of 3.8x10mm3
E. WBC count of 7.5x10mm3
