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 C

Explanation

A. Blistering burns are not a typical side effect of radiation therapy for laryngeal cancer. Radiation burns can occur on the skin, but they are more likely to cause irritation and redness rather than blistering burns, especially in the case of internal radiation targeting the larynx.
B. Diarrhea is a common side effect of radiation therapy when the abdominal or pelvic areas are treated, but it is not typically associated with radiation therapy to the larynx.
C. Dry mouth (xerostomia) is a common side effect of radiation therapy for laryngeal cancer, as the salivary glands may be affected by the radiation. This results in reduced saliva production, leading to a dry mouth.
D. Nausea is not a typical side effect of radiation therapy for laryngeal cancer specifically, though it may occur if other areas (such as the stomach) are being treated. Nausea is more commonly associated with chemotherapy.

A. "Test your blood glucose level every 8 hours." B. "Check your urine for ketones when blood glucose levels are greater than 240 mg/dL." C. "Withhold your usual daily dose of insulin." D. "Drink 240 to 360 milliliters of calorie-free liquids every 8 hours."

Correct Answer is B

Explanation

A. "Test your blood glucose level every 8 hours.": This is incorrect. During illness, blood glucose levels should be checked more frequently, typically every 2 to 4 hours, to closely monitor for hyperglycemia and prevent diabetic ketoacidosis (DKA). Checking every 8 hours may not be frequent enough, especially if the client is ill or experiencing stress, both of which can affect blood sugar.
B. "Check your urine for ketones when blood glucose levels are greater than 240 mg/dL.": This is the correct instruction. When blood glucose levels exceed 240 mg/dL, it is important to check for ketones in the urine. The presence of ketones can indicate the development of DKA, and early detection can prevent the condition from worsening.
C. "Withhold your usual daily dose of insulin.": This is incorrect. Insulin should never be withheld during periods of illness unless specifically instructed by a healthcare provider. Withholding insulin can increase the risk of DKA, as the body will continue to break down fat for energy in the absence of insulin, leading to ketosis.
D. "Drink 240 to 360 milliliters of calorie-free liquids every 8 hours.": This is not entirely correct. While staying hydrated is important, the recommendation is generally to drink more frequently, ideally 8 ounces of fluid every hour to stay well-hydrated. It is also recommended to drink fluids that contain some carbohydrates (such as electrolyte-containing drinks) to help manage blood glucose levels during illness.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which side effect of radiation therapy will the nurse anticipate in a patient who has laryngeal cancer?

Correct Answer is C

Explanation

A nurse is reviewing guidelines to prevent DKA during periods of illness with a client who has type 1 diabetes mellitus. Which of the following instructions should the nurse include in the teaching?

Correct Answer is B

Explanation

The nurse suspects which cause of increased bubbling in the water seal chamber of a patient's chest drainage unit?

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A nurse is providing teaching to a client who has a new diagnosis of type 2 diabetes mellitus. The nurse should recognize that the client understands the teaching when he identifies which of the following as manifestations of hypoglycemia? (Select all that apply.)

A patient's status post hypophysectomy had drainage on the mustache dressing. Which complication is this patient at risk for if the glucose level of the drainage is 50 mg/dL?

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After giving 6 oz of orange juice to a patient with hypoglycemia, the nurse finds that the patient's blood glucose level is 65 mg/dl. Which nursing intervention would be the most appropriate in this situation?