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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Correct Answer is D

Explanation

A. The "Choice of Analgesia and Sedation" component of the ABCDEF assessment tool focuses on selecting appropriate pain relief and sedation strategies for the patient but does not directly relate to the weaning process.
B. "Assess, Prevent, and Manage Pain" involves ensuring the patient is comfortable and free from pain, which is important but not specifically related to weaning from the ventilator.
C. "Delirium: Assess, Prevent, and Manage" addresses the cognitive status of the patient, particularly the prevention and management of delirium, which is a critical aspect of care but not directly related to ventilator weaning.
D. "Breathing: Spontaneous Awakening Trials (SAT) and Spontaneous Breathing Trials (SBT)" directly involves the weaning process, as it includes assessing the patient's ability to breathe independently by reducing or removing sedation (SAT) and evaluating their capacity for spontaneous breathing (SBT).

A. Dry oral mucous membranes B. Tremors C. White coating in the mouth D. Nausea

Correct Answer is C

Explanation

A. Dry oral mucous membranes can occur with the use of inhalers but are not a serious adverse effect of beclomethasone. It can be managed with proper hydration and is not typically a cause for concern.
B. Tremors are more commonly associated with bronchodilators, such as beta-agonists, rather than corticosteroids like beclomethasone. They are not a typical side effect of beclomethasone MDI.
C. A white coating in the mouth may indicate oral thrush, a fungal infection caused by Candida species, which is a known adverse effect of inhaled corticosteroids like beclomethasone. The client should be instructed to rinse their mouth after each use to prevent this complication and report any signs of oral thrush to the provider.
D. Nausea is not a common adverse effect of inhaled corticosteroids. It is more often associated with systemic medications rather than inhaled therapies.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with weaning a client from the ventilator. Which of the following parts of the ABCDEF assessment tool does the weaning process represent?

Correct Answer is D

Explanation

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?

Correct Answer is C

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?

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

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

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A nurse is collecting data from a client who has a respiratory disorder and displays manifestations of hypoxia. Which of the following findings should the nurse expect?

Which of the following best describes the primary physiological role of B-type natriuretic peptide (BNP) in the regulation of cardiovascular function?

A nurse is caring for a client in the emergency department (ED) who has high anxiety and shallow respirations at a rate of 30/min. Which of the following acid-base disturbances is the client most likely experiencing?

Exhibits

What is the most appropriate initial management for this patient?