A nurse is caring for a patient at risk for atelectasis.

Which independent nursing measure should the nurse prioritize to prevent the development of atelectasis?

Ambulation.

Oxygen therapy.

Incentive spirometry.

Increase oral fluid intake.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Ambulation is a general measure that can help improve overall lung function by promoting deep breathing, coughing, and mobilization of secretions. However, it is not the primary measure to prevent atelectasis.
Choice B rationale
Oxygen therapy is used to treat hypoxia, which can be a result of atelectasis. However, it does not directly prevent the development of atelectasis.
Choice C rationale
Incentive spirometry is a first-line measure to prevent atelectasis. It encourages deep breathing, which helps keep the alveoli inflated and can prevent them from collapsing, thus preventing atelectasis.
Choice D rationale
Increasing oral fluid intake can help to thin secretions, making them easier to mobilize. However, it is not the primary measure to prevent atelectasis.

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Correct Answer is D

Explanation

Choice A rationale
While it’s true that appetite and sense of smell are closely linked, the return of appetite does not necessarily mean the return of the sense of smell, especially after a total laryngectomy.
Choice B rationale
The body does not develop an ability to smell through the stoma. The sense of smell is primarily mediated by the olfactory nerve (Cranial Nerve I), which is located in the upper part of the nasal cavity.
Choice C rationale
The sense of smell does not typically return after several months following a total laryngectomy. This is because the surgery involves removal of the larynx and separation of the airway from the mouth, nose and throat.
Choice D rationale
Breathing through a stoma after a total laryngectomy does alter the sense of smell. This is because the nose and mouth are bypassed during breathing, and these are the primary routes for smell.

A. Thoracentesis. B. Obtain ABGs. C. Computed tomography (CT) of the chest. D. Prepare for insertion of a chest tube. E. Obtain intravenous access. F. Pulmonary Function Tests (PFTS). .

Correct Answer is ["A","B","C","D","E"]

Explanation

Choice A rationale
Thoracentesis may be performed to remove air from the pleural space in a client with a pneumothorax.
Choice B rationale
Obtaining arterial blood gases (ABGs) can help assess the client’s respiratory status and the severity of the pneumothorax.
Choice C rationale
A computed tomography (CT) scan of the chest can provide detailed images of the lungs and can help confirm the diagnosis of a pneumothorax.
Choice D rationale
Preparation for the insertion of a chest tube may be necessary to remove air from the pleural space and allow the lung to re-expand in a client with a pneumothorax.
Choice E rationale
Obtaining intravenous access is often necessary for administering medications and fluids.

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A nurse is caring for a patient at risk for atelectasis. Which independent nursing measure should the nurse prioritize to prevent the development of atelectasis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who reports experiencing an alteration in sense of smell following surgery for a total laryngectomy. The nurse should address the patient’s concern through which of the following responses?

Correct Answer is D

Explanation

A nurse is caring for a client who has a pneumothorax. The nurse is reviewing the client’s medical record. What prescriptions should the nurse anticipate for a client who has a pneumothorax?

Correct Answer is ["A","B","C","D","E"]

Explanation

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A nurse is caring for a patient at risk for atelectasis.

Which independent nursing measure should the nurse prioritize to prevent the development of atelectasis?