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66. A client with end-stage chronic obstructive pulmonary disease requires bi-level positive airway pressure (BiPAP). While caring for the client, the nurse determines that bilateral wrist restraints are required to prevent compromised care. Which client care outcome is associated with restraint use in the client who requires BiPAP?
a) The client will remain infection-free
b) The client will maintain adequate oxygenation.
c) The client will maintain adequate urine output
d) The client will remain pain-free
67. A 52-year-old client who just emigrated from Mexico is admitted with tuberculosis. The client explains to the nurse through an interpreter that he's concerned about paying for his medications after discharge. The nurse should collaborate with which health care team member about the client's financial concerns?
a) Public health worker
b) Home health nurse
c) Physician
d) Social worker
68. During the insertion of a rigid scope for bronchoscopy, a client experiences a vasovagal response. The nurse should expect
a) The client's pupils to become dilated
b) The client to experience bronchodilation
c) A decrease in the client's gastric secretions.
d) A drop in the client's heart rate.
69. A client with chronic sinusitis comes to the outpatient department complaining of headache, malaise, and a nonproductive cough. When examining the client's paranasal sinuses, the nurse detects tenderness. To evaluate this finding further, the nurse should transilluminate the:
a) frontal sinuses only
b) sphenoidal sinuses only
c) frontal and maxillary sinuses
d) sphenoidal and ethmoidal sinuses.
70. A client with severe acute respiratory syndrome (SARS) privately informs the nurse that he doesn't want to be placed on a ventilator if his condition worsens. The client's wife and children have repeatedly expressed their desire that everything be done for the client. The most appropriate action by the nurse would be to.
a) inform the family of the client's wishes.
b) assure the family that everything possible will be done.
c) support the client's decision
d) assure the client that everything possible will be done.
Respiratory NCLEX Practice Questions
Answers and Rationale
66) B
- BiPAP is a type of continuous
positive airway pressure in which both inspiratory and expiratory
pressures are set above atmospheric pressure. This type of ventilatory
support assists clients with chronic obstructive pulmonary disease who
retain PaCO2. Restrains are necessary in this client to maintain BiPAP
therapy if the client attempts to dislodge the mask despite instruction
no to do so. Maintaining oxygenation is the expected outcome in this
client. Options A, C, and D aren't direct outcomes of the client
requiring BiPAP who needs restraints to maintain client safety.
67) D
- The nurse should
collaborate with the social worker about the client's financial
concerns. This collaboration can be done independently without a
physician's order. The physician must only notify the public health
department of the client's diagnoses. The physician and home health
nurse are also involved in the client's care but aren't typically
involved with the client's financial concerns until after the client is
discharged
68) D
- During a bronchoscopy, a
vasovagal response may be caused by stimulating the pharynx, and it, in
turn, may cause stimulation vagus nerve. The client may, therefore,
experience a sudden drop in heart rate leading to syncope. Stimulation
of the vagus nerve doesn't lead to pupillary dilation or
bronchodilation, Stimulation of the vagus nerve increases gastric
secretions.
69) C
- After detecting tenderness of the
paranasal sinuses, the nurse should transilluminate both frontal and
maxillary sinuses; lack of illumination may indicate sinus congestion
and pus accumulation. The sphenoidal and ethmoidal sinuses can't be
transilluminated because of their location.
70) C
- The nurse is obligated
to act as client advocate. The nurse shouldn't discuss the issue with
the client's family unless the client gives permission. Answers B and D
oppose the client's wishes and don't demonstrate client advocacy
After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:
Respiratory NCLEX Practice Questions (1-6)
Or proceed to the next set of questions:
Respiratory NCLEX Practice Questions (66-70)