Nursing Elites

1. A client has a disposable three-chamber chest tube in place. Which of the following findings should indicate to the nurse that the client is experiencing a complication?

• A. Continuous bubbling in the water-seal chamber
• B. Occasional bubbling in the water-seal chamber
• C. Constant bubbling in the suction-control chamber
• D. Fluctuations in the fluid level in the water-seal chamber

Correct answer: A

Rationale: Continuous bubbling in the water-seal chamber indicates air is leaking into the pleural space, which is a complication. The water-seal chamber should have intermittent bubbling during normal functioning. Occasional bubbling in the water-seal chamber is normal and shows the system is working as intended. Constant bubbling in the suction-control chamber suggests an issue with the suction control. Fluctuations in the fluid level in the water-seal chamber are an expected finding.

2. During pulmonary hygiene for a client with pneumonia, a nurse positions the client on his left side in Trendelenburg position. From which of the following lung segments should the nurse expect secretions to be mobilized with the client in this position?

• A. Lateral segment of the left lower lobe
• B. Lateral segment of the right lower lobe
• C. Posterior segment of the right middle lobe
• D. Posterior segment of the right lower lobe

Correct answer: B

Rationale: When a client is positioned on the left side in Trendelenburg position for pulmonary hygiene, secretions are expected to be mobilized from the lateral segment of the right lower lobe. This positioning helps facilitate drainage and clearance of secretions from this specific area of the lung, aiding in overall pulmonary hygiene and improving ventilation.

3. A client is moving to a new state and needs to find a new doctor and hospital there. What advice by the nurse is best?

• A. Ask the hospitals there about standard nurse-client ratios.
• B. Choose the hospital that has the newest technology.
• C. Find a hospital that is accredited by The Joint Commission.
• D. Use a facility affiliated with a medical or nursing school.

Correct answer: C

Rationale: Choosing a hospital accredited by The Joint Commission (TJC) or another accrediting body is the best advice as it ensures a focus on safety and quality standards.

4. A nurse collaborates with a respiratory therapist to complete pulmonary function tests (PFTs) for a client. Which statements should the nurse include in communications with the respiratory therapist prior to the tests? (SATA)

• A. I held the client's morning bronchodilator medication.
• B. The client is ready to go down to radiology for this examination.
• C. Physical therapy states the client can run on a treadmill.
• D. I advised the client not to smoke for 6 hours prior to the test.

Correct answer: B

Rationale: To ensure the PFTs are accurate, the therapist needs to know that no bronchodilators have been administered in the past 4 to 6 hours, the client did not smoke within 6 to 8 hours prior to the test and the client can follow basic commands, including different breathing maneuvers. The respiratory therapist can perform PFTs at the bedside. A treadmill is not used for this test.

5. A nurse is teaching a client who is obese and has obstructive sleep apnea how to decrease the number of nightly apneic episodes. Which of the following client statements indicates an understanding of the teaching?

• A. "It might help if I tried sleeping only on my back."
• B. "I'll sleep better if I take a sleeping pill at night."
• C. "I'll get a humidifier to run at my bedside at night."
• D. "If I could lose about 50 pounds, I might stop having so many apneic episodes."

Correct answer: D

Rationale:

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