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A patient is admitted to the respiratory unit with flail chest. The nurse understands that a flail chest is:

A condition in which the ribs are fractured in multiple places, resulting in a segment of the chest wall that moves independently during respiration

A condition in which the chest wall is paralyzed, resulting in difficulty breathing

A condition in which the lungs are unable to fully expand, resulting in decreased oxygenation

A condition in which the diaphragm becomes weak, resulting in decreased lung expansion

Answer and Explanation

The Correct Answer is A

A. Flail chest occurs when multiple ribs are fractured in more than one location, creating a free-floating segment of the chest wall. This segment moves paradoxically during respiration, meaning it moves inward during inspiration and outward during expiration, which impairs effective breathing and oxygenation.

B. Paralysis of the chest wall may occur in conditions like spinal cord injuries but is not the defining characteristic of flail chest.

C. While decreased oxygenation can occur with flail chest due to impaired ventilation, the defining feature is the paradoxical movement of the fractured rib segment.

D. Weakness of the diaphragm can impair lung expansion, but this is characteristic of conditions like diaphragmatic paralysis, not flail chest.

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Correct Answer is B

Explanation

A. Oxygen at 4L per minute is generally too high for clients with COPD. High oxygen concentrations can suppress their hypoxic drive, which is their primary mechanism for breathing.

B. Oxygen at 2L per minute is the appropriate starting rate for clients with COPD. This flow rate provides supplemental oxygen without significantly increasing the risk of suppressing the client’s respiratory drive.

C. Oxygen at 6L per minute is excessive for clients with COPD and can lead to complications such as hypercapnia or respiratory depression.

D. Oxygen at 8L per minute is not recommended for clients with COPD unless specifically ordered in a life-threatening situation, as it can suppress their respiratory drive and worsen their condition.

A. Fluticasone B. Amoxicillin C. Isosorbide dinitrate D. Carvedilol

Correct Answer is D

Explanation

A. Fluticasone is an inhaled corticosteroid often used to manage asthma. It does not pose a direct risk to a client with heart failure and asthma, so clarification is not needed for this medication.

B. Amoxicillin is an antibiotic and does not directly affect asthma or heart failure. It is not contraindicated in clients with these conditions, so clarification is not necessary.

C. Isosorbide dinitrate is a nitrate used to treat heart failure by reducing cardiac workload and improving oxygen delivery. It does not affect asthma and does not require clarification.

D. Carvedilol is a beta-blocker that is commonly used to manage heart failure, but it is a non-selective beta-blocker, which can exacerbate asthma symptoms by causing bronchoconstriction. In clients with a history of asthma, beta-1 selective blockers are preferred, so clarification of this order is necessary.

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A patient is admitted to the respiratory unit with flail chest. The nurse understands that a flail chest is:

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Naxlex Comprehensive Predictor Exams

A nurse is applying oxygen via nasal cannula to a client diagnosed with chronic obstructive pulmonary disease (COPD). The client reports extreme shortness of breath. At what rate should the nurse set the flowmeter?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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