A nurse is caring for a client who has acute respiratory distress syndrome (ARDS) and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes?

Decrease respiratory secretions.

Induce sedation

Suppress respiratory effort

Decrease chest wall compliance

Answer and Explanation

The Correct Answer is C

Choice A reason: Decrease respiratory secretions. This answer is incorrect because pancuronium does not have any effect on the production or clearance of respiratory secretions. This medication is not used to treat the pulmonary edema and inflammation that occur in ARDS.

Choice B reason: Induce sedation. This answer is incorrect because pancuronium does not have any sedative or analgesic properties. This medication does not affect the level of consciousness or pain perception of the client. A client who receives pancuronium should also receive adequate sedation and analgesia to prevent anxiety and discomfort.

Choice C reason: Suppress respiratory effort. This answer is correct because pancuronium is a neuromuscular blocker that inhibits the transmission of nerve impulses to the muscles, causing paralysis and relaxation. This medication is used to suppress the respiratory effort of the client and allow the mechanical ventilator to control the breathing.

Choice D reason: Decrease chest wall compliance. This answer is incorrect because pancuronium does not have any effect on the elasticity or stiffness of the chest wall. This medication is not used to treat the reduced lung compliance and increased airway resistance that occur in ARDS.

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Correct Answer is B

Explanation

Choice A reason: The client is unable to make vocal sounds. This conclusion is not based on the GCS score of 5 for best verbal response, which indicates that the client is oriented and converses normally. The client may have other reasons for being unable to make vocal sounds, such as intubation or injury to the vocal cords.

Choice B reason: The client opens his eyes when spoken to. This conclusion is based on the GCS score of 3 for eye opening, which indicates that the client responds to verbal stimuli. This is the highest level of eye opening response on the GCS.

Choice C reason: The client is unconscious. This conclusion is not based on the GCS score of 13 (3+5+5), which indicates that the client has a mild level of impaired consciousness. The client is not unconscious, but may have reduced awareness or attention.

Choice D reason: The client can follow simple motor commands. This conclusion is not based on the GCS score of 5 for best motor response, which indicates that the client localizes pain. This means that the client moves their limbs away from a painful stimulus, but does not necessarily follow commands.

A. My partner should place their food on the weaker side of their mouth when eating. B. My partner should tilt their head forward when swallowing. C. My partner should cough while swallowing food. D. My partner should sit at a 30° angle while eating their meals.

Correct Answer is B

Explanation

Choice A reason: Placing food on the weaker side of the mouth when eating is not an effective strategy for a client who has dysphagia. This can increase the risk of choking or aspiration, as the food may not be chewed properly or may slip into the airway. The client should place food on the stronger side of the mouth and use the tongue to move it to the back of the throat for swallowing.

Choice B reason: Tilting the head forward when swallowing is an effective technique for a client who has dysphagia. This can help to close off the airway and prevent food or liquid from entering the lungs. The client should also tuck the chin down to the chest and swallow hard.

Choice C reason: Coughing while swallowing food is not a desirable outcome for a client who has dysphagia. This can indicate that the food is going into the wrong pipe and causing irritation or obstruction. The client should try to avoid coughing while swallowing and clear the throat after each bite or sip.

Choice D reason: Sitting at a 30° angle while eating meals is not a sufficient position for a client who has dysphagia. This can still allow food or liquid to flow back into the throat and cause choking or aspiration. The client should sit upright at a 90° angle and remain in that position for at least 30 minutes after eating.

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A nurse is caring for a client who has acute respiratory distress syndrome (ARDS) and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes?

Nursing Test Bank

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Correct Answer is B

Explanation

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Correct Answer is B

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