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56. A client has a left pleural effusion that has not yet been treated. The nurse plans to have which of the following items available for immediate use?
a) intubation tray
b) paracentesis tray
c) thoracentesis tray
d) central nervous line insertion tray
57. A client with acute respiratory distress syndrome has an order to be placed on a continuous positive airway pressure (CPAP) face mask. The nurse implements which of the following for this procedure to be most effective?
a) obtains baseline arterial blood gases
b) obtains baseline pulse oximetry levels
c) applies the mask to the face with a snug fit
d) encourages the client to remove the mask frequently for coughing and deep breathing exercises
58. The nurse is teaching a client with chronic obstructive pulmonary disease (COPD) how to do pursed-lip breathing. Evaluation of understanding is evident if the client demonstrates which of the following?
a) breathes in and then holds the breath for 30 seconds
b) loosens the abdominal muscles while breathing out
c) breathes so that expiration is three times as long as inspiration
d) inhales with pursed lips and exhales with the mouth open wide
59. A physician is inserting a chest tube. The nurse selects which of the following materials to be used as the first layer of the dressing at the chest tube insertion site?
a) sterile 4x4 gauze pad
b) petrolatum jelly gauze
c) absorbent gauze dressing
d) gauze impregnated with povidone-iodine
60. A client being seen in the physician's office for follow-up 2 weeks after pneumonectomy complains of numbness and tenderness at the surgical site. The nurse tells the client that this is:
a) not likely to be permanent, but may last for some months
b) a severe problem and the client will probably be rehospitalized
c) probably caused by permanent nerve damage as a result of surgery
d) often the first sign of a wound infection and checks the client's temperature
NCLEX Review Respiratory Questions
Answers and Rationale
56) C
- The client with a significant pleural effusion is usually treated by thoracentesis. This procedure allows drainage of the fluid, which may then be analyzed to determine the precise cause of the effusion. The nurse ensures that a thoracentesis tray is readily available in case the client's symptoms should rapidly become more severe. A paracentesis tray is needed for the removal of abdominal effusion. Options A and D are not specifically indicated for this procedure.
57) C
- The face mask must be applied over the nose and mouth with a snug fit, which is necessary to maintain positive pressure in the client's airways. The nurse obtains baseline respiratory assessments and arterial blood gases to evaluate the effectiveness of therapy, but these are not done to increase the effectiveness of the procedure. A disadvantage of the CPAP face mask is that the client must remove it for coughing, eating, or drinking. This removes the benefit of positive pressure in the airway each time it is removed.
58) C
- Prolonging expiration time reduces air trapping caused by airway narrowing that occurs in COPD. Tightening (not loosening) the abdominal muscles aids in expelling air. Exhaling through pursed lips (not with the mouth wide open) increases the intraluminal pressure and prevents the airways from collapsing. The client is not instructed to breathe in and hold the breath for 30 seconds; this action has no useful purpose for the client with COPD.
59) B
- The first layer of the chest tube dressing is petrolatum gauze, which allows for an occlusive seal at the chest tube insertion site. Additional layers of gauze cover this layer, and the dressing is secured with a strong adhesive tape or Elastoplast tape.
60) A
- Clients who undergo pneumonectomy may experience numbness, altered sensation, or tenderness in the area that surrounds the incision. These sensations may last for months. It is not considered to be a severe problem and is not indicative of a wound infection.
After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:
NCLEX Review Respiratory Questions (1-6)
Or proceed to the next set of questions:
NCLEX Review Respiratory Questions (61-65)
