A critical-care nurse is caring for a client diagnosed with pneumonia as a surgical complication. The nurse’s assessment reveals that the client has an increased work of breathing due to copious tracheobronchial secretions. What should the nurse encourage the patient to do?

Lie in a low Fowler’s or supine position

Increase oral fluids unless contraindicated

Increase activity

Call the nurse for oral suctioning as needed

Answer and Explanation

The Correct Answer is D

A. Lie in a low Fowler’s or supine position:

Lying in a low Fowler's or supine position may worsen respiratory distress and compromise oxygenation. It can reduce lung expansion and increase the work of breathing, especially in patients with pneumonia. This is not a recommended position for individuals with respiratory issues.

B. Increase oral fluids unless contraindicated:

Increasing oral fluids is generally a good practice, especially in respiratory conditions like pneumonia. It helps thin respiratory secretions, making them easier to clear. However, this alone may not address copious tracheobronchial secretions. Suctioning may be needed to effectively remove excess secretions.

C. Increase activity:

Increasing activity may be beneficial for some patients, but it might exacerbate respiratory distress in others, especially if they are already experiencing increased work of breathing. The appropriateness of increasing activity depends on the specific condition and the patient's overall stability.

D. Call the nurse for oral suctioning as needed:

This is the most appropriate choice. If the client is experiencing increased work of breathing due to copious tracheobronchial secretions, calling the nurse for oral suctioning is an intervention aimed at maintaining a clear airway and alleviating respiratory distress. Regular suctioning may be necessary to assist the client in managing secretions effectively.

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Correct Answer is C

Explanation

A. Obtain a sputum sample:

This option is more relevant when the client is experiencing cough with sputum production, which might suggest respiratory issues. However, in the context of coughing after eating or drinking, the primary concern is likely related to the swallowing process rather than respiratory conditions.

B. Inspect the client’s tongue and mouth:

While inspecting the tongue and mouth is a good practice for assessing oral health, it may not directly address the issue of coughing after eating or drinking, which is more indicative of potential swallowing difficulties.

C. Perform a swallowing assessment:

This is the most appropriate option for the given scenario. A swallowing assessment helps identify any abnormalities or difficulties in the swallowing process, which could contribute to the client's coughing after eating or drinking.

D. Assess the client’s nutritional status:

While assessing nutritional status is important for overall health, it may not directly address the immediate concern of coughing after eating or drinking. Nutritional status assessment is a broader aspect of care.

A. The patient pain reflects the target heart rate has been set too high and needs to be lowered to finish the test. B. The patient’s pain reflects pericarditis and the test should be stopped. C. The patient’s pain reflects ischemia to the myocardium and the test should be stopped. D. The patient’s pain reflects that supplemental oxygen is needed to finish the test.

Correct Answer is C

Explanation

A. The patient pain reflects the target heart rate has been set too high and needs to be lowered to finish the test.

This option suggests that the chest pain is related to the target heart rate being set too high. However, chest pain during an exercise stress test is more commonly associated with myocardial ischemia rather than an inappropriate target heart rate. Lowering the target heart rate may not address the underlying issue of ischemia.

B. The patient’s pain reflects pericarditis and the test should be stopped.

Chest pain during an exercise stress test is more commonly associated with myocardial ischemia rather than pericarditis. Pericarditis is inflammation of the pericardium, and its symptoms may include chest pain that is often sharp and pleuritic. However, during an exercise stress test, the focus is on detecting cardiovascular abnormalities, and chest pain is more concerning for ischemia.

C. The patient’s pain reflects ischemia to the myocardium and the test should be stopped.

This is the most appropriate interpretation. Chest pain during an exercise stress test may indicate insufficient oxygen supply to the myocardium (ischemia). Stopping the test allows for further evaluation and appropriate intervention.

D. The patient’s pain reflects that supplemental oxygen is needed to finish the test.

Chest pain during an exercise stress test is not typically addressed by providing supplemental oxygen. Stopping the test and evaluating the cause of the chest pain is a more appropriate action.

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A critical-care nurse is caring for a client diagnosed with pneumonia as a surgical complication. The nurse’s assessment reveals that the client has an increased work of breathing due to copious tracheobronchial secretions. What should the nurse encourage the patient to do?

Nursing Test Bank

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Correct Answer is C

Explanation

The nurse is caring for a client who is undergoing an exercise stress test. Prior to reaching the target heart rate, the client develops chest pain. What is the nurse’s most appropriate interpretation of the chest pain?

Correct Answer is C

Explanation

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