Choice A rationale
Implementing ventilator-weaning protocols is a crucial intervention in the care plan for a patient on a ventilator to prevent ventilator-associated pneumonia. These protocols aim to minimize the patient’s exposure to mechanical ventilation, which is a significant risk factor for developing ventilator-associated pneumonia. By systematically reducing the level of ventilatory support, these protocols facilitate the earliest possible liberation from mechanical ventilation, thereby reducing the risk of ventilator-associated pneumonia.
Choice B rationale
Providing frequent oral care is another essential intervention in preventing ventilator- associated pneumonia. Oral health can quickly deteriorate in mechanically ventilated patients, leading to an increased risk of ventilator-associated pneumonia. Regular oral care, including the use of antiseptics, can help reduce the number of potential respiratory pathogens in the oral cavity and prevent their aspiration into the lower respiratory tract.
Choice C rationale
Suctioning the patient every hour is not typically recommended as a standard intervention to prevent ventilator-associated pneumonia. Over-suctioning can lead to trauma and inflammation in the airway, potentially increasing the risk of infection. Suctioning should be performed based on the patient’s needs and clinical signs, rather than on a fixed schedule.
Choice D rationale
Positioning the patient in a semi-upright position (30 to 45 degrees), rather than a prone position, is recommended to prevent ventilator-associated pneumonia. This position helps to reduce the risk of aspiration, which is a major risk factor for ventilator-associated pneumonia.
Choice E rationale
Avoiding suctioning the patient is not a recommended strategy for preventing ventilator- associated pneumonia. Suctioning is necessary to clear secretions from the airway, and its omission could potentially increase the risk of infection. However, as mentioned earlier, suctioning should be performed based on the patient’s needs and clinical signs, rather than on a fixed schedule.

Step 1 is to determine the amount of cefaclor in each milliliter of the oral suspension. This is done by dividing the total amount of cefaclor in the suspension (250 mg) by the total volume of the suspension (5 mL). So, 250 mg ÷ 5 mL = 50 mg/mL.

Step 2 is to calculate the volume of the suspension that contains the prescribed dose of cefaclor (500 mg). This is done by dividing the prescribed dose by the amount of cefaclor in each milliliter of the suspension. So, 500 mg ÷ 50 mg/mL = 10 mL. Therefore, the nurse should administer 10 mL of the cefaclor oral suspension per dose.

Choice A rationale
While the application of anti-embolism stockings can be beneficial in preventing deep vein thrombosis in postoperative patients, it is not the most prioritized nursing intervention in the immediate postoperative period for a patient who has undergone a left pneumonectomy. The immediate postoperative period after a pneumonectomy is critical for monitoring and managing potential complications such as respiratory distress, hemorrhage, and bronchopleural fistula.
Choice B rationale
The use of the incentive spirometer is an important nursing intervention for postoperative patients to promote lung expansion and prevent atelectasis. However, in the immediate postoperative period following a pneumonectomy, the priority is to monitor for complications and ensure the stability of the patient.
Choice C rationale
Assessment of the chest tube and pleur-evac is the most prioritized nursing intervention in the immediate postoperative period for a patient who has undergone a left pneumonectomy. After a pneumonectomy, a chest tube is placed to drain air, blood, and fluid from the pleural space to allow the remaining lung to re-expand. It is crucial to monitor the chest tube system for proper functioning and to assess for complications such as excessive bleeding, infection, or pneumothorax.
Choice D rationale
Repositioning the patient in bed is a standard nursing intervention in postoperative care to enhance comfort, promote lung expansion, and prevent complications such as pressure ulcers and deep vein thrombosis. However, it is not the most prioritized intervention in the immediate postoperative period following a pneumonectomy, where monitoring for respiratory complications and ensuring the stability of the patient are paramount.

Choice A rationale
This response is not appropriate as it does not address the patient’s emotional state and may come across as dismissive or coercive. It is important to approach a tearful and refusing patient with empathy and understanding, acknowledging their feelings and concerns.
Choice B rationale
This response is the most appropriate as it acknowledges the patient’s emotional state and opens up a dialogue for the patient to express their worries or concerns. By asking the patient what is worrying them, the nurse shows empathy and provides an opportunity for the patient to voice their fears or concerns, which can be the first step towards resolving the issue.
Choice C rationale
This response is not appropriate as it does not address the patient’s emotional state and may come across as dismissive or coercive. It is important to approach a tearful and refusing patient with empathy and understanding, acknowledging their feelings and concerns.
Choice D rationale
This response is not appropriate as it may come across as dismissive or insensitive. It is important to approach a tearful and refusing patient with empathy and understanding, acknowledging their feelings and concerns.

Choice A rationale
While being able to drink water through a straw without choking is a positive sign, it is not the primary indicator that a patient can safely resume oral liquids after a bronchoscopy. The primary indicator is the return of the patient’s cough and swallowing reflexes.
Choice B rationale
The patient has intact cough and swallowing reflexes is the primary indicator that a patient can safely resume oral liquids after a bronchoscopy. These reflexes are essential for preventing aspiration, which can lead to pneumonia.
Choice C rationale
While clear breath sounds upon auscultation are a positive sign, they are not the primary indicator that a patient can safely resume oral liquids after a bronchoscopy. The primary indicator is the return of the patient’s cough and swallowing reflexes.
Choice D rationale
The absence of a sore throat is not the primary indicator that a patient can safely resume oral liquids after a bronchoscopy. The primary indicator is the return of the patient’s cough and swallowing reflexes.

Choice A rationale
While it’s possible for a virus to reactivate in the body, this is not typically the case with the common cold. The common cold is a viral infection primarily in the nose, with most people recovering in seven to ten days.
Choice B rationale
While it’s true that cold season tends to end as the weather warms up, this doesn’t address the patient’s concern about their repeated colds. It’s important to note that colds are caused by viruses, which can be spread year-round, although they are more common in the colder months.
Choice C rationale
This is the correct answer. The common cold is indeed a virus that can be spread by a person two days before they experience any symptoms. This means that people can spread the virus before they know they’re sick, which can make it difficult to avoid catching a cold.
Choice D rationale
While wearing a mask can help prevent the spread of viruses, it’s not typically necessary for someone who is simply sensitive to colds. Masks are more commonly recommended for people who are already sick to prevent them from spreading the virus, or for people who are at high risk of serious complications from the cold.

Choice A rationale
Following ventilator-weaning protocols is an important intervention to prevent ventilator-associated pneumonia. Weaning protocols help to reduce the duration of mechanical ventilation, which is a risk factor for developing ventilator-associated pneumonia.
Choice B rationale
Providing frequent mouth care is a key intervention in preventing ventilator-associated pneumonia. Good oral hygiene can help to reduce the amount of bacteria in the mouth that can potentially be aspirated into the lungs.
Choice C rationale
Suctioning the patient every hour is not typically recommended as a method to prevent ventilator-associated pneumonia. Over-suctioning can potentially damage the lung tissue and mucous membranes, and it can also increase the risk of introducing bacteria into the lungs.
Choice D rationale
Placing the patient in a prone position can help to improve oxygenation and reduce the risk of ventilator-associated pneumonia. The prone position can help to drain secretions from the lungs, reducing the risk of bacteria growth and infection.
Choice E rationale
Refraining from suctioning the patient is not a recommended intervention to prevent ventilator-associated pneumonia. Suctioning is necessary to remove secretions from the airway, which can help to prevent infection.

Choice A rationale
Offering high-protein and high-carbohydrate foods frequently is an important intervention for a client who has acute respiratory distress syndrome (ARDS)4. These nutrients can provide the energy needed for the increased metabolic demands of ARDS and support the healing process.
Choice B rationale
Administering low-flow oxygen continuously via nasal cannula is not typically the main treatment for ARDS5. ARDS is a severe condition that often requires high levels of supplemental oxygen delivered through methods that can provide higher concentrations of oxygen than a nasal cannula.
Choice C rationale
Encouraging oral intake of at least 3,000 mL of fluids per day is not a typical intervention for a client with ARDS4. While adequate hydration is important, too much fluid can worsen lung function in clients with ARDS4. Fluid management in ARDS is typically carefully controlled and may involve diuretics to remove excess fluid.
Choice D rationale
Repositioning and placing the client in a prone position is not a typical intervention for all clients with ARDS4. While some clients with severe ARDS may benefit from prone positioning, this is not a standard intervention for all clients with ARDS4.

Choice A rationale
Using chewing tobacco every day is a significant risk factor for laryngeal cancer. Tobacco contains many carcinogens, which can damage the cells in the larynx and lead to cancer.
Choice B rationale
Being an industrial-commercial painter is associated with an increased risk of laryngeal cancer. This is likely due to exposure to certain chemicals and toxins that are used in paints and other materials.
Choice C rationale
Being an ultrasound technician is not typically associated with an increased risk of laryngeal cancer. Ultrasound technicians are not generally exposed to the types of toxins or risk factors that are associated with laryngeal cancer.
Choice D rationale
Wearing magnetic healing bracelets is not associated with an increased risk of laryngeal cancer. There is no scientific evidence to suggest that these bracelets have any effect on cancer risk.
Choice E rationale
Having a spouse who smokes cigarettes is a risk factor for laryngeal cancer. Secondhand smoke, also known as passive smoke, contains many of the same carcinogens as the smoke inhaled by smokers. Exposure to secondhand smoke can increase a person’s risk of developing laryngeal cancer.

Choice A rationale
A non-productive cough is not a definitive sign of inadequate drug therapy for tuberculosis. It could be a symptom of many other respiratory conditions.
Choice B rationale
Decreased shortness of breath is generally a positive sign indicating improvement in the patient’s condition. It does not necessarily indicate inadequate drug therapy.
Choice C rationale
The presence of positive acid-fast bacilli in the sputum after 2 months of treatment indicates that the tuberculosis bacteria are still present in the patient’s body. This suggests that the triple antibiotic therapy is not effectively eliminating the bacteria, thus indicating inadequate drug therapy.
Choice D rationale
Poor appetite is a common symptom of tuberculosis, but it does not specifically indicate the effectiveness or inadequacy of drug therapy.