A nurse is teaching a client who has pneumonia about the use of an incentive spirometer. Which of the following instructions should the nurse Include?

"Tilt the spirometer toward yourself so you can see the balls rise."

"Inhale deeply and hold each breath for a minimum of 10 seconds."

"Exhale before sealing your lips around the mouthpiece."

"Use your incentive spirometer every 4 hours while you are awake."

Answer and Explanation

The Correct Answer is D

A) "Tilt the spirometer toward yourself so you can see the balls rise": Tilting the spirometer is not necessary and may affect its accuracy. The spirometer should be held in an upright position to ensure correct measurement of inhalation.

B) "Inhale deeply and hold each breath for a minimum of 10 seconds": Inhaling deeply is important, but holding each breath for 10 seconds is not a typical recommendation for using an incentive spirometer. The goal is to inhale deeply and slowly, without necessarily holding the breath for an extended period.

C) "Exhale before sealing your lips around the mouthpiece": Exhaling before using the spirometer is not recommended. The correct procedure involves inhaling deeply and slowly after sealing your lips around the mouthpiece to ensure accurate measurement and effective lung expansion.

D) "Use your incentive spirometer every 4 hours while you are awake": Frequent use of the incentive spirometer, often every hour while awake, is recommended to improve lung function and prevent complications such as atelectasis. Using it every 4 hours may not be sufficient for effective respiratory therapy.

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

Explanation

A) Urticaria:
Urticaria, or hives, is a skin reaction characterized by itchy, raised welts. It is not typically associated with a small bowel obstruction, which primarily affects the gastrointestinal system rather than the skin.

B) Vomiting:
Vomiting is a common symptom of a complete small bowel obstruction. It occurs due to the blockage in the intestines, which prevents the passage of contents, leading to nausea and vomiting as the body tries to expel the obstruction.

C) Distended abdomen:
A distended abdomen is expected in cases of small bowel obstruction. The blockage causes a buildup of gas and fluids, leading to abdominal swelling and distention as the normal passage of intestinal contents is impeded.

D) Fluid overload:
Fluid overload is not a typical manifestation of a small bowel obstruction. Instead, dehydration and electrolyte imbalances are more likely due to vomiting and the inability to absorb fluids and nutrients properly.

E) Obstipation:
Obstipation, or severe constipation with an inability to pass stool or gas, is a key sign of a complete small bowel obstruction. The obstruction prevents the normal movement of intestinal contents, leading to a cessation of bowel movements.

A. Sensorineural deafness B. Maculopapular rash C. Swelling of the parotid glands D. Nuchal rigidity

Correct Answer is C

Explanation

A) Sensorineural deafness
This is a possible complication of mumps but not a symptom indicating the illness stage. It can occur after the infection and does not reflect the active phase of the disease.

B) Maculopapular rash
This type of rash is not typically associated with mumps. It may indicate other viral infections, such as measles or rubella, rather than mumps.

C) Swelling of the parotid glands
Swelling of the parotid glands is a hallmark symptom of the illness stage of mumps. This swelling typically appears a few days after the onset of other symptoms like fever and malaise and signifies the active phase of the infection.

D) Nuchal rigidity
Nuchal rigidity can occur if there is mumps-related meningitis, but it is not a typical sign of the initial illness stage. It indicates potential complications involving the central nervous system.

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A nurse is teaching a client who has pneumonia about the use of an incentive spirometer. Which of the following instructions should the nurse Include?

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has a complete small bowel obstruction. Which of the following manifestations should the nurse expect? (Select all that apply.)

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

Explanation

A nurse is assessing a client who has the communicable disease mumps. Which of the following findings should the nurse identify as indicating the client is in the illness stage?

Correct Answer is C

Explanation

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