Exhibits
What is the most appropriate initial management for this patient?
Apply positive pressure ventilation and provide supportive care with pain management.
Perform needle decompression of the pleural space followed by chest tube insertion.
Administer intravenous antibiotics and arrange for an elective surgical repair.
Provide high-flow oxygen and intubate the patient for mechanical ventilation.
The Correct Answer is B
A. Apply positive pressure ventilation and provide supportive care with pain management: While supportive care is important, positive pressure ventilation may not be sufficient to address the underlying issue, which is likely a pneumothorax or hemothorax.
B. Perform needle decompression of the pleural space followed by chest tube insertion: This is the most appropriate initial management for a patient with paradoxical chest wall movement, which is a sign of flail chest and likely pneumothorax. Needle decompression can relieve pressure in the pleural space, and chest tube insertion can help drain any fluid or air that has accumulated.
C. Administer intravenous antibiotics and arrange for an elective surgical repair: While infection may be a concern, it is not the most immediate priority in this case. The patient's respiratory distress needs to be addressed first.
D. Provide high-flow oxygen and intubate the patient for mechanical ventilation: While oxygen therapy may be necessary, intubation should be considered as a last resort if other measures fail to improve oxygenation. In this case, needle decompression and chest tube insertion are more likely to be effective in improving respiratory function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Hyperkalemia: Hyperkalemia involves elevated potassium levels, which can cause muscle weakness, cardiac arrhythmias, and other symptoms, but it is not associated with Trousseau's sign or bone pain.
B. Hypermagnesemia: Hypermagnesemia, an elevated magnesium level, typically causes symptoms such as muscle weakness and respiratory depression, but not Trousseau's sign or bone pain.
C. Hypocalcemia: Hypocalcemia, characterized by low calcium levels, is commonly associated with a positive Trousseau's sign (spasms induced by inflating a blood pressure cuff) and bone pain due to calcium's role in bone health and neuromuscular function.
D. Hyponatremia: Hyponatremia refers to low sodium levels, which can cause symptoms like confusion, seizures, and lethargy, but it is not related to Trousseau's sign or bone pain.
Correct Answer is A
Explanation
A. Encourage the client to drink more fluids: Increasing fluid intake helps thin respiratory secretions, making them easier to clear from the lungs. Hydration is crucial in managing pneumonia to help with mucus mobilization.
B. Encourage regular use of the incentive spirometer: While the incentive spirometer helps with lung expansion and preventing atelectasis, it does not directly affect the viscosity of secretions.
C. Encourage coughing and deep breathing: Coughing and deep breathing are important for clearing secretions, but they are more effective once the secretions are already thin. Drinking fluids is a more direct method to thin the secretions.
D. Encourage the client to ambulate more often: Ambulation is beneficial for overall respiratory health and lung function, but it does not directly thin respiratory secretions. Increasing fluid intake is more effective for this purpose.
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