Which patient does the LPN/LVN identify at high risk for hospital-acquired pneumonia?

A 35-year-old patient using the incentive spirometer following abdominal surgery

A 55-year-old patient who is eating in the chair following a rhinoplasty

A 40-year-old patient who refuses to cough and deep breath following a splenectomy

A24-year-old patient ambulating in the hall following an appendectomy

Answer and Explanation

The Correct Answer is C

C. This patient is at high risk for hospital-acquired pneumonia. After a splenectomy (removal of the spleen), patients may experience pain and discomfort, which can make them reluctant to perform necessary activities like coughing and deep breathing. These activities are crucial for preventing lung complications such as atelectasis and pneumonia.
A. This patient is actively using an incentive spirometer, which is a device that encourages deep breathing and helps keep the lungs clear. This practice significantly reduces the risk of developing pneumonia by preventing atelectasis (collapse of part of the lung) and promoting lung expansion.

B. This patient is out of bed and eating, which indicates they are relatively mobile and maintaining normal respiratory function. Rhinoplasty, a surgical procedure on the nose, generally does not impair lung function or significantly increase the risk of pneumonia. Being active and upright further reduces the risk of HAP.
D. This patient is actively ambulating, which is highly beneficial for lung function and overall recovery. Walking and moving around helps to prevent respiratory complications, including pneumonia, by promoting lung expansion and circulation.

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Correct Answer is A

Explanation

A. This range is generally considered acceptable for most patients with COPD. It provides a balance between ensuring adequate oxygenation while avoiding the risk of oxygen toxicity. Oxygen saturation levels within this range can help alleviate symptoms of hypoxemia without causing hyperoxia.
B. Oxygen saturation levels below 90% can lead to significant hypoxemia and exacerbate respiratory distress in individuals with COPD. Maintaining oxygen saturation levels above 90% is typically recommended to prevent complications associated with hypoxemia.
C. This range is appropriate for some patients but it may not be ideal for all patients with COPD. Oxygen saturation levels at the higher end of this range (e.g., 100%) can increase the risk of oxygen toxicity in patients with COPD who retain carbon dioxide (CO2) due to their chronic respiratory condition.
D. Oxygen saturation levels within this range help to balance the need for oxygen supplementation with the risk of hyperoxia and oxygen toxicity. However, individual patient factors, such as the severity of COPD, baseline oxygen saturation levels, and comorbidities, should be considered when determining the target range for oxygen saturation.

A. Take the medication with an antacid. B. Take as needed for pain relief. C. Store the medication in the refrigerator. D. Take the medication 1 hr before meals.

Correct Answer is D

Explanation

D. Sucralfate should be taken on an empty stomach, typically 1 hour before meals. This timing allows the medication to coat the ulcer site effectively and protect it from the acidic environment of the stomach, which increases after eating.
A. Taking sucralfate with an antacid can interfere with its action. Sucralfate works by forming a protective barrier on the ulcer site, and antacids can prevent sucralfate from binding properly to the ulcer. It's generally recommended to take sucralfate at least 30 minutes before or after antacids.
B. Sucralfate is not taken on an "as needed" basis for pain relief. It is prescribed as a regular, scheduled medication to provide continuous protection of the ulcer site. Pain relief from peptic ulcers comes as the ulcer heals, which sucralfate aids by protecting the mucosal lining.
C. Sucralfate does not need to be stored in the refrigerator. It should be stored at room temperature, away from moisture and heat, according to standard storage guidelines for most medications.

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Which patient does the LPN/LVN identify at high risk for hospital-acquired pneumonia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What is the desired peripheral capillary oxygen saturation (Spo2) level in the patient with chronic obstructive pulmonary disease?

Correct Answer is A

Explanation

A nurse is reinforcing teaching a client who has peptic ulcer disease and is starting therapy with sucralfate. Which of the following instructions should the nurse include in the teaching?

Correct Answer is D

Explanation

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A nurse is reinforcing teaching for a client who has a duodenal ulcer and a new prescription for sucralfate. The client asks the nurse how sucralfate works. Which of the following statements should the nurse make?

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