which is the proper hand position for performing chest vibration

NCLEX-PN

Next Generation Nclex Questions Overview 3.0 ATI Quizlet

1. Which is the proper hand position for performing chest vibration?

A. cup the hands
B. use the side of the hands
C. flatten the hands
D. spread the fingers of both hands

Correct answer: C

Rationale: The correct hand position for performing chest vibration is to flatten the hands. By flattening the hands over the area of the body where chest percussion is applied, vibrations can be conducted effectively to the chest to help loosen secretions. Cupping the hands may dampen vibrations, using the side of the hands reduces the surface area in contact with the chest, and spreading the fingers can lead to uneven pressure distribution. Therefore, flattening the hands provides the necessary contact and surface area to perform chest vibration efficiently.

2. A nurse provides instructions to a mother about crib safety for her infant. Which statement by the mother indicates a need for further instructions?

A. ''Wood surfaces on the crib need to be free of splinters and cracks.''
B. ''I need to keep large toys out of the crib.''
C. ''The distance between the slats needs to be no more than 4 inches wide to prevent entrapment of my infant's head or body.''
D. ''The drop side needs to be impossible for my infant to release.''

Correct answer: ''The distance between the slats needs to be no more than 4 inches wide to prevent entrapment of my infant's head or body.''

Rationale: The correct answer is, ''The distance between the slats needs to be no more than 4 inches wide to prevent entrapment of my infant's head or body.'' This statement indicates a need for further instructions as the distance between the slats should be no more than 2⅜ inches to prevent entrapment of the infant’s head and body, not 4 inches. Allowing a larger gap can pose a risk of entrapment or injury to the infant. Keeping large toys out of the crib is essential to prevent the infant from using them to climb out, which could result in serious injuries. Ensuring the drop side of the crib is impossible for the infant to release is crucial to prevent falls and injuries. Additionally, maintaining wood surfaces on the crib free of splinters, cracks, and lead-based paint is vital for the infant's safety and well-being.

3. A nurse is preparing for the admission of a client with pulmonary tuberculosis. Which action reflects the use of evidence-based practice in the care of the client?

A. Keeping the door to the client’s room closed
B. Fitting the client for an N95 or HEPA (high-efficiency particulate air) mask to be worn at all times
C. Placing the client in a semiprivate room with a cohort client
D. Using a surgical mask when entering the client’s room

Correct answer: Keeping the door to the client’s room closed

Rationale: Evidence-based practice is an approach to client care that integrates the client’s preferences, clinical expertise, and the best research evidence to deliver quality care. In the case of pulmonary tuberculosis, which is transmitted through the airborne route, keeping the door to the client’s room closed is crucial to prevent the spread of infection. Placing the client in a semiprivate room with a cohort client is not recommended for airborne precautions; a private room is required to prevent transmission. Fitting the client for an N95 or HEPA mask is essential for the nurse's protection when entering the room, not for the client to wear at all times. Using a surgical mask when entering the client’s room is not sufficient for airborne precautions; an N95 or HEPA mask is necessary.

4. Which of the following is not a function of parathyroid hormone?

A. moving calcium from bones to the bloodstream
B. inhibiting renal tubular reabsorption of phosphorus
C. promoting renal tubular reabsorption of calcium
D. enhancing renal production of vitamin D metabolites

Correct answer: inhibiting renal tubular reabsorption of phosphorus

Rationale: The correct answer is 'inhibiting renal tubular reabsorption of phosphorus.' Parathyroid hormone actually inhibits renal tubular reabsorption of phosphorus, making this choice the opposite of its function. Parathyroid hormone functions to move calcium from bones to the bloodstream (Choice A), promote renal tubular reabsorption of calcium (Choice C), and enhance renal production of vitamin D metabolites (Choice D). Therefore, all other choices are functions of parathyroid hormone except for the inhibition of phosphorus reabsorption.

5. What is the most appropriate feeding method for a client who is unable to swallow?

A. Nothing by mouth
B. Nasogastric feedings
C. Clear liquids
D. Total parenteral nutrition

Correct answer: Nasogastric feedings

Rationale: Nasogastric feedings are the most appropriate feeding method for a client who is unable to swallow. Providing nothing by mouth can lead to nutritional deficiencies, while clear liquids might cause aspiration. Total parenteral nutrition is not necessary if the gastrointestinal tract is functional. Nasogastric feedings are preferred as they can safely provide nutrition without the risks associated with not eating or aspirating.