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.

Answer and Explanation

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.

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Free Nursing Study Resources

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

Explanation

A. Dyspnea: Shortness of breath is a common and significant symptom of COPD, resulting from the narrowing of airways and difficulty in expelling air.

B. Chronic cough: A persistent cough, often productive, is a hallmark of COPD. It is typically a response to chronic irritation and inflammation of the airways.

C. Wheezing: Wheezing is a common symptom of COPD due to the constriction of airways and turbulent airflow through narrowed airways.

D. Sputum production: Increased sputum production is common in COPD, especially in chronic bronchitis type of COPD, where inflammation leads to excess mucus production.

E. Chest tightness: While chest tightness can occur in COPD, it is less commonly emphasized compared to the other symptoms listed. The primary symptoms are generally more focused on dyspnea, cough, wheezing, and sputum production.

A. Reposition the client every 4 hr. B. Place the head of the client's bed at 40° when supine. C. Turn off the ventilator alarms before suctioning the client's airway. D. Provide mouth care every 10 to 12 hr with hydrogen peroxide.

Correct Answer is B

Explanation

A. Reposition the client every 4 hr.: Repositioning should be done more frequently, typically every 2 hours, to prevent complications such as pressure ulcers.

B. Place the head of the client's bed at 40° when supine: Elevating the head of the bed to 30-45° helps reduce the risk of ventilator-associated pneumonia (VAP) by preventing aspiration.

C. Turn off the ventilator alarms before suctioning the client's airway: Ventilator alarms should never be turned off as they are critical for monitoring the client's status. Alarms can be temporarily silenced, but only for the duration of the procedure.

D. Provide mouth care every 10 to 12 hr with hydrogen peroxide: Mouth care should be provided more frequently, typically every 4 hours, to reduce the risk of infection. Hydrogen peroxide is not commonly used due to its potential to cause irritation and harm to oral tissues.

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Exhibits What is the most appropriate initial management for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following are the most common manifestations of COPD? (Select all that apply.)

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

Explanation

A nurse at a long-term care facility is reinforcing teaching with a newly hired nurse about the care of clients who are receiving mechanical ventilation. Which of the following information should the nurse include?

Correct Answer is B

Explanation

A nurse is collecting data for a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?

Which of the following is the most common risk factor for emphysema?

A nurse is providing a client who has COPD with education regarding adapting their behavior. Which of the following describes an anticipated outcome following education of the client?

A nurse is reinforcing discharge instructions for a client who has asthma and is about to start using beclomethasone MDI. For which of the following findings should the nurse instruct the client to monitor and report to the provider as an adverse effect of the medication?

A nurse is collecting data for a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?

A nurse is caring for a client who has asthma and allergies. The client asks the nurse about environmental influences they should avoid. The nurse should inform the client to avoid which of the following?

A nurse is caring for a client who has hypernatremia and is receiving intravenous (IV) hypotonic fluid replacement. Which of the following manifestations should the nurse understand is an indication of an adverse effect from the administration of hypotonic fluids?

Exhibits

What is the most appropriate initial management for this patient?