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Foundations of Nursing Chapters 37, 38, 41
Terms in this set (50)
To assess for atelectasis
To assess for pneumonia
While caring for a patient with chest tubes, the nurse asks the patient to rate the level of comfort on scale of 0 to 10. What could be the rationale behind this?
The nurse is caring for a patient who was admitted to the hospital with a diagnosis of left-sided heart failure. While assessing the patient, which signs and symptoms would the nurse likely find?
A patient with lung disease has difficulty producing a cough. The primary health care provider prescribes chest physiotherapy. After chest physiotherapy, which technique is beneficial for the patient?
The nurse is caring for a patient who has a pneumothorax and has chest tubes. Which position does the nurse prefer to treat the patient effectively?
"I should practice the exercise initially in the sitting position and then in the supine position."
The registered nurse is teaching a patient about diaphragmatic breathing. Which statement if made by the patient indicates the need for further teaching?
Perform chest compression; establish airway and breathing.
The nurse pays a home visit to a patient on a home oxygen-delivery system. The nurse finds that the patient is lying on the bed and is not breathing, and there is no pulse. What is the nurse's immediate next step?
Chest tubes are catheters inserted through lungs to remove air from the pleural space.
Which statement is true regarding chest tubes?
The patient has peripheral crackles in all lobes.
Which is an indication for suctioning a patient's endotracheal (ET) tube?
Decreased oxygen-carrying capacity
The hemoglobin level of a patient who has pallor and looks weak is 8 g/dL. Upon assessment, the patient's heart rate is 110 bpm and respiratory rate is 30 breaths per minute. Which physiological factor is directly responsible for this condition?
Which oxygen delivery system is indicated for long-term oxygen use at home?
"A new sterile catheter should be used for every suction session."
A registered nurse explains to a nursing student about the factors to be considered when performing closed suctioning. Which of the nursing student's statements indicates a need for further teaching?
Hyperoxygenating the patient before suctioning
Which nursing intervention, if performed before suctioning, minimizes hypoxemia after suctioning?
"The use of normal saline instillation into the airway before endotracheal and tracheostomy suctioning is avoided."
A registered nurse teaches a nursing student about suctioning safety guidelines. Which statement if made by the nursing student indicates a need for further education?
Decreased circulation of blood volume
A nurse assesses a patient and determines there are color changes to the skin due to hypoxia. What may be the cause of this change?
"Normal saline solution should be instilled into artificial airways."
The registered nurse is teaching a nursing student about the care for patients with artificial airways. Which statements should the nurse exclude from the teaching?
78 years old
The chest x-ray of a patient with a respiratory infection shows an enlarged and calcified trachea and bronchi. What would be the patient's age?
Ventilation is the process of moving gases into and out of the lungs.
Which statement is true regarding ventilation?
To reduce the risk of accidental extubation
While inserting an endotracheal tube, the nurse instructs the patient to avoid coughing. What is the rationale behind this instruction?
It is used while transporting the patient.
Which statement about a simple face mask is true?
When intermittent delivery of oxygen is needed while suctioning is being performed
When is it appropriate to use this catheter shown in the image below?
"The chest tube system should be open and above the chest."
The registered nurse is teaching a nursing student about special considerations while inserting a patient's chest tube. Which statement if made by the nursing student indicates a need for further teaching?
Administering 2 L/min of O 2
A nurse is caring for a patient who has chronic obstructive pulmonary disease (COPD). Based on the patient's laboratory reports, which nursing intervention may benefit the patient?
Cleaning the inner cannula
Reporting the patient's respiratory status
Reporting unexpected drainage from the tracheostomy tube
Which aspects of care for a patient with a tracheostomy can be safely delegated to nursing assistive personnel?
What complications are associated with invasive mechanical ventilation?
Which condition may be observed in a patient who receives frequent suctioning?
Encourage the patient to identify fears and verbalize feelings.
A patient newly diagnosed with colon cancer has withdrawn from family members. Which strategy should the nurse use to assist the patient at this time?
"Do you live alone or with others?"
While interviewing a patient who is experiencing a developmental crisis, the nurse is assessing the patient's perception of stressors. Which question should the nurse ask during the assessment?
Listen to concerns and provide reassurance.
If the family of a dying patient is highly emotional and critical of the nursing care, which action by the nurse is appropriate?
Sense of depersonalization
The nurse is caring for a patient with grief and loss due to the death of a grandfather. Which behavioral symptom observed by nurse indicates normal grief?
After 6 weeks when she adjusts to the child's respiratory status and reestablishes the entitlement checks
A crisis intervention nurse is working with a mother whose Down syndrome child has been hospitalized with pneumonia. During this hospitalization, the mother lost her entitlement check. When should the nurse expect the mother to regain stability?
An actual loss occurs when a person can no longer feel, hear, see, or know a person.
Which statement is true regarding types of loss?
Sharing time with the patient
Respecting the patient as a whole person
Valuing the things that the patient cares about
Which nursing actions help to promote the dignity of the patient experiencing grief?
Stages of dying
Which theory of grief and mourning includes denial and acceptance?
The nurse working in a psychiatric unit teaches a patient about crisis management. What are the various forms of crises?
Observe the patient's appearance.
Ask the patient about changes in eating patterns.
Ask the patient about changes in his or her sleeping pattern.
Observe the patient's response to the questions asked.
The nurse is interviewing a 37-year-old patient who is not coping well with a recent loss of employment. Which activities should the nurse perform to assess coping in the patient?
A search for identity with peer groups and separation from family
The nurse plans care for a 16-year-old male taking into consideration the stressors experienced most commonly by adolescents. What should the nurse consider?
"What is bothering you most right now?"
"Have you started drinking and smoking?"
"Has your caffeine intake increased?"
A patient is diagnosed with breast cancer. She is upset about the diagnosis. What questions should the nurse ask to assess the coping skills of the patient?
"This was the doctor's fault for not finding this earlier."
The nurse is caring for a patient in the terminal stage of leukemia. Which statement indicates the patient is experiencing the anger stage of the Kübler-Ross theory of grief and mourning?
Identifying sources of social support
Providing opportunities to express positive life events
A patient is diagnosed with advanced leukemia. The patient is hopeless about the treatment. Which nursing interventions would help the patient to overcome the lack of hope?
A patient who is having difficulty managing his diabetes mellitus responds to the news that his hemoglobin A1c, a measure of blood sugar control over the past 90 days, has increased by saying, "The hemoglobin A1c is wrong. My blood sugar levels have been excellent for the last 6 months." Which defense mechanism is the patient using?
A patient refuses to accept the death of a child. The patient no longer has a job, avoids communication with others, and remains aloof. Which grief type is indicated by the patient's presentation?
Adjusting to chronic illness
Accepting physical aging
Paying for medical bills and expenses
The nurse is attending to a patient with violent behavior. The patient is diagnosed with posttraumatic stress disorder (PTSD), paranoia, and psychosis. What factors can contribute to situational stress for this patient?
A patient is experiencing memory loss due to a severe brain injury sustained in a car accident. The patient is unable to recollect her own name or that of family members and is unable to perform activities of daily living. Which loss has the patient sustained that may need further evaluation?
Offer family members the option to view the body.
Use periods of silence during the conversation.
The hospice nurse is caring for the family of a patient who has just died. Which interventions should the nurse implement in caring for the family?
Inability to swallow.
Increased periods of sleeping.
Coolness and cyanosis in extremities.
The nurse is closely monitoring a patient who is critically ill with a chronic disease. Which physical changes indicate that the patient will die soon, and the nurse should inform the family?
Apply a moist cloth to the patient's lips.
Give fluids through a nasogastric tube.
Provide mouth care every 8 hours.
The nurse finds that a terminally ill patient who is in a home hospice setting is dehydrated. Which nursing actions should the nurse perform?
Supporting the family's efforts to adjust to the loss
Helping the family to accept the reality of the loss.
A patient passed away after a massive heart attack 5 days following hospitalization. Which nursing actions should be performed for the family to facilitate mourning?
"Listen to music that you enjoy."
"Exercise for 15 to 30 minutes every day."
"Engage yourself in pleasurable activities."
The nurse is teaching stress management techniques to a patient. Which instructions should the nurse give the patient to manage stress?
It is triggered directly by a physical event.
It involves the autonomic nervous and endocrine systems.
It is initiated by the pituitary gland after a physical injury.
The nurse is teaching a group of nursing students about the general adaptation syndrome (GAS). What is true about this phenomenon?
"I can sit with you for a while, if you would like to talk."
After a health care provider has informed a patient that he has colon cancer, the nurse enters the room to find the patient gazing out the window in thought. What is the nurse's first response?
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