Chapter 27: Lower Respiratory Problems Lewis: Medical-Surgical Nursing, 10th Edition Exam Practice Questions and Answers
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Course
Lewis Medical-Surgical Nursing
Institution
Lewis Medical-Surgical Nursing
Chapter 27: Lower Respiratory
Problems Lewis: Medical-Surgical
Nursing, 10th Edition Exam Practice
Questions and Answers
After assessment of a patient with pneumonia, the nurse identifies a nursing diagnosis of ineffective
airway clearance. Which assessment data best supports this diagnosis?
...
Patients should continue to cough and deep breathe after discharge. Fatigue is expected for several
weeks. The pneumococcal and influenza vaccines can be given at the same time in different arms. A
follow-up chest x-ray needs to be done in 6 to 8 weeks to evaluate resolution of pneumonia.
DIF: Cognitive Level: Apply (application)
Which action should the nurse plan to prevent aspiration in a high-risk patient?
a. Turn and reposition an immobile patient at least every 2 hours.
b. Place a patient with altered consciousness in a side-lying position.
c. Insert a nasogastric tube for feeding a patient with high calorie needs.
d. Monitor respiratory symptoms in a patient who is immunosuppressed. - Ans:✔✔-ANS: B
With loss of consciousness, the gag and cough reflexes are depressed, and aspiration is more likely to
occur. The risk for aspiration is decreased when patients with a decreased level of consciousness are
placed in a side-lying or upright position. Frequent turning prevents pooling of secretions in immobilized
patients but will not decrease the risk for aspiration in patients at risk. Monitoring of parameters such as
breath sounds and O2 saturation will help detect pneumonia in immunocompromised patients, but it
will not decrease the risk for aspiration. Conditions that increase the risk of aspiration include decreased
level of consciousness (e.g., seizure, anesthesia, head injury, stroke, alcohol intake), difficulty swallowing,
and nasogastric intubation with or without tube feeding.
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