The nurse assists a patient into which position in preparation for a diagnostic thoracentesis?

Sitting upright with elbows on an over-bed table and feet supported

Sitting in bed with knees slightly flex and feet flexed

Lying flat in the fetal position on the unaffected side

Lying flat on the unaffected side with knees slightly flexed

Answer and Explanation

The Correct Answer is A

A. The optimal position for a thoracentesis is sitting upright with the patient leaning forward slightly, with elbows resting on an over-bed table to help expose the pleural space for access. This position allows gravity to pull the lungs downward and facilitates easier access to the pleural cavity.
B. Sitting in bed with knees slightly flexed and feet flexed is not the best position for thoracentesis. This position might limit the ability to properly expose the thoracic cavity for the procedure.
C. Lying flat in the fetal position on the unaffected side would not allow for effective drainage or access to the pleural space and is not ideal for thoracentesis.
D. Lying flat on the unaffected side with knees slightly flexed is not ideal because it does not provide optimal positioning for the procedure. The upright position is preferred for thoracentesis to facilitate easy access to the pleural space.

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Correct Answer is A

Explanation

A. The client is likely experiencing an allergic reaction to penicillin, such as anaphylaxis, which can cause symptoms like itching, dizziness, and difficulty breathing. The first step is to stop the infusion immediately to prevent further exposure to the allergen.
B. Elevating the head of the bed might be helpful if the client is experiencing respiratory distress, but stopping the infusion is the priority action.
C. Auscultating the client's breath sounds may be useful later to assess the severity of respiratory distress, but it is not the first action in an acute allergic reaction.
D. Calling the provider is important, but the immediate priority is stopping the infusion to prevent further harm from the allergic reaction.

A. Tachypnea B. Bradycardia C. Hypothermia D. Pulse deficit

Correct Answer is A

Explanation

A. Tachypnea, or rapid breathing, is a common finding in pneumonia due to hypoxia and the body's attempt to compensate for impaired gas exchange in the lungs. It is one of the hallmark signs of pneumonia.
B. Bradycardia is uncommon in pneumonia. Tachycardia (increased heart rate) is more frequently observed as the body compensates for the infection and reduced oxygenation.
C. Hypothermia is not typically associated with pneumonia; more commonly, fever (hyperthermia) is present as a sign of infection.
D. A pulse deficit is a sign of a heart condition, such as atrial fibrillation, not typically related to pneumonia.

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The nurse assists a patient into which position in preparation for a diagnostic thoracentesis?

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