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
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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Have the client refrain from talking for 24 hr: The client only needs to refrain from talking until the anesthesia wears off, usually within an hour. There is no need to refrain from talking for 24 hours.
B. Withhold food and liquids until the client's gag reflex returns: This is the correct action. Following a bronchoscopy, the local anesthetic used can suppress the gag reflex. It is crucial to wait until the gag reflex returns to prevent aspiration when the client eats or drinks. C. Irrigate the client's throat every 4 hr: There is no indication to irrigate the throat routinely. The priority is to ensure that the gag reflex has returned before allowing oral intake.
D. Suction the client's oropharynx frequently: Suctioning is only necessary if the client is unable to clear their secretions or has difficulty breathing. It is not a standard post-procedure intervention.
Correct Answer is B
Explanation
A. HCO3 (bicarbonate) levels above 26 mEq/L indicate alkalosis, not acidosis. In metabolic acidosis, the HCO3 levels would be low as the body attempts to neutralize excess acid.
B. In metabolic acidosis, the pH is expected to be below 7.35 because metabolic acidosis indicates an accumulation of acid or loss of bicarbonate, which lowers the blood pH.
C. PaO2 (partial pressure of oxygen) below 70 mm Hg typically indicates hypoxemia, not necessarily metabolic acidosis. The primary concern with metabolic acidosis is the balance of acid-base status, not oxygenation.
D. PaCO2 above 45 mm Hg would suggest respiratory acidosis rather than metabolic acidosis. In metabolic acidosis, the body compensates by hyperventilating to blow off CO2 and raise the pH, resulting in a normal or low PaCO2.
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