RESPIRATORY EVOLVE EXAM 2024 |COMPLETE EXAM QUESTIONS
AND CORRECT ANSWERS WITH RATIONALES |VERIFIED ANSWERS
ALREADY GRADED A+
During the evening after a thoracentesis, the client reports anxiety.
Which action would the nurse take first?
A. Administer the prescribed analgesic.
B. Listen to the client's breath sounds.
C. Give the client the prescribed as needed lorazepam.
D. Ask the client about specific concerns or worries. - ANSWER -ANS:
B
Listen to the client's breath sounds.
Because anxiety is frequently an early manifestation of hypoxemia,
the nurse's initial action will be to assess for complications of
thoracentesis such as pneumothorax by listening for lung sounds.
A. Administering an analgesic may be indicated if the client states
that pain is contributing to anxiety, but would be done after further
assessment.
C. Administration of lorazepam may be indicated after the nurse
assesses for potential physiological or psychological causes of
anxiety.
,D. Asking about specific client concerns or worries is indicated
once the nurse is sure that physiological factors are not the cause of
the anxiety.
Which assessment finding on a client who has just had a
thoracentesis for a right pleural effusion would require the most rapid
action by the nurse?
A. Oxygen saturation of 93%
B. Blood pressure of 160/94 mm Hg
C. Decreased right side breath sounds
D. Ecchymosis at the site of the thoracentesis - ANSWER -ANS: C
Decreased right breath sounds
After thoracentesis the breath sounds should be audible on the
affected side and decreased breath sounds may indicate
pneumothorax. The nurse would immediately notify the health care
provider and expect actions such as a chest x-ray and possible
insertion of a chest tube.
A. The oxygen saturation of 93% is slightly below normal, but
would not be surprising in a client who has a history of lung disease.
B. Hypotension after thoracentesis may indicate bleeding or that
too much pleural fluid has been removed at once, but mild
hypertension may occur due to anxiety or pain.
,D. Ecchymosis at the thoracentesis site would be monitored, but
would be expected after thoracentesis.
Immediately after a thoracentesis, a client's right lung collapses. A
chest tube is inserted and is attached to a three-chamber closed
drainage system. The nurse assesses the fluid in the system and
recognizes that which finding indicates that the chest tube is
functioning properly?
A. The fluid remains constant in the chest drainage chamber.
B. The fluid is bubbling gently in the chest drainage chamber.
C. The fluid is bubbling vigorously in the suction control chamber. D.
The fluid rises in the tube of the water-seal chamber during
inspiration. - ANSWER -ANS: D
The fluid rises in the tube of the water-seal chamber during
inspiration.
Increased negative intrapleural pressure on inspiration causes the
fluid to rise; a decrease in negative intrapleural pressure on
expiration causes the fluid to fall.
A. Remaining constant in the chest drainage chamber indicates
that an obstruction is present in the drainage tubing or that the
suction is too low; a slight increase in fluid should be evident in this
chamber postoperatively.
, B. Bubbling gently in the chest drainage chamber indicates an air
leak.
C. If the water is bubbling vigorously in the suction control
chamber, the suction is too hight; bubbling should be gentle.
After a thoracentesis for pleural effusion, a client returns to an
outpatient clinic for a follow-up visit. The nurse suspects a recurrence
of pleural effusion when the client makes which statement?
A. "Lately I can only breathe well if I sit up."
B. "During the night I sometimes get the chills."
C. "I get a sharp, stabbing pain when I take a deep breath." D. "I'm
coughing up large amounts of thicker mucus for the past several
days." - ANSWER -ANS: C
"I get a sharp, stabbing pain when I take a deep breath."
Rationale:
Tension is placed on the pleura at the height of inspiration and
causes pain.
A. The response "Lately I can only breathe well if I sit up" is typical
of heart failure."
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller nyagajoseph539. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $25.99. You're not tied to anything after your purchase.
