A client who is in the end stage of chronic bronchitis tells the nurse, “I don’t know how my wife will manage without me.” The most appropriate response by the nurse at this time is:

Would you like to see a member of the clergy to receive a blessing?

Do you have children who can help your wife?

Do you have a living will?

Have you discussed your feelings with your wife?

Answer and Explanation

The Correct Answer is D

Choice A reason: Asking if the client would like to see a member of the clergy to receive a blessing can be supportive, but it may not directly address the client’s immediate emotional needs. While spiritual support is important, the nurse should first focus on the client’s expressed concerns about their wife.

Choice B reason: Inquiring if the client has children who can help their wife is practical, but it may not address the client’s emotional distress. The nurse should prioritize providing emotional support and facilitating communication between the client and their family.

Choice C reason: Asking if the client has a living will is important for end-of-life planning, but it does not directly address the client’s emotional concerns. This question is more appropriate for a discussion about advance directives rather than an immediate response to the client’s expressed worries

Choice D reason: Encouraging the client to discuss their feelings with their wife is the most appropriate response. It addresses the client’s emotional needs and promotes open communication between the client and their spouse. This can help alleviate some of the client’s anxiety and ensure that their wife is aware of their feelings and concerns.

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Correct Answer is A

Explanation

Choice A reason:

Hemoglobin, 8.0 g/dL: Hemoglobin is a critical component of red blood cells, responsible for carrying oxygen throughout the body. Normal hemoglobin levels typically range from 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women1. A level of 8.0 g/dL is significantly below the normal range, indicating anemia. Severe anemia can increase the risk of perioperative complications, including poor wound healing, increased risk of infection, and cardiovascular stress. Therefore, this result should be reported to the surgeon as it may necessitate postponing the surgery until the anemia is addressed.

Choice B reason:

Serum creatinine, 0.8 mg/dL: Creatinine is a waste product produced by muscles and filtered out of the blood by the kidneys. Normal serum creatinine levels range from 0.74 to 1.35 mg/dL for men and 0.59 to 1.04 mg/dL for women. A level of 0.8 mg/dL falls within the normal range, indicating normal kidney function. Therefore, this result would not typically cause surgery to be postponed.

Choice C reason:

Platelets, 210,000/mm³: Platelets are essential for blood clotting. Normal platelet counts range from 150,000 to 400,000/mm³. A count of 210,000/mm³ is within the normal range, indicating adequate clotting ability. Thus, this result would not be a reason to postpone surgery.

Choice D reason:

Sodium, 144 mEq/L: Sodium is an essential electrolyte that helps regulate fluid balance, nerve function, and muscle contractions. Normal sodium levels range from 135 to 145 mEq/L. A level of 144 mEq/L is within the normal range, indicating normal electrolyte balance. Therefore, this result would not typically cause surgery to be postponed.

A. Suction the client at least every two hours. B. Encourage fluids up to 3000 mL/day unless contraindicated. C. Encourage a right side-lying position. D. Administer codeine elixir PRN following prescription.

Correct Answer is B

Explanation

Choice A reason: Suctioning the client at least every two hours is not typically necessary for a non-productive cough. Suctioning is more appropriate for patients with excessive secretions that they cannot clear on their own. Overuse of suctioning can cause irritation and discomfort.

Choice B reason: Encouraging fluids up to 3000 mL/day unless contraindicated is crucial for a client with pneumonia. Adequate hydration helps to thin mucus, making it easier to expectorate and clear from the lungs. This can improve the client’s ability to cough effectively and reduce the risk of complications such as atelectasis. Hydration also supports overall bodily functions and helps in maintaining electrolyte balance.

Choice C reason: Encouraging a right side-lying position is not the best intervention for a client with right lower lobe pneumonia. This position may not promote optimal lung expansion and drainage. Instead, positioning the client to maximize lung expansion and facilitate drainage, such as sitting up or lying on the unaffected side, is more beneficial.

Choice D reason: Administering codeine elixir PRN following prescription is not the priority intervention. While codeine can help suppress a cough, it is generally not recommended for a non-productive cough in pneumonia because it can suppress the cough reflex needed to clear secretions. Additionally, codeine can cause respiratory depression and other side effects.

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A client who is in the end stage of chronic bronchitis tells the nurse, “I don’t know how my wife will manage without me.” The most appropriate response by the nurse at this time is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which laboratory result of a preoperative client should the nurse report to the surgeon’s office, knowing that it could cause surgery to be postponed?

Correct Answer is A

Explanation

The client has right lower lobe pneumonia with a non-productive cough. Which intervention is the nurse’s priority?

Correct Answer is B

Explanation

The nurse must administer 1600 mL of total parenteral nutrition (TPN) over 24 hours. The nurse should set the IV pump to deliver how many mL/hr? (Round to the nearest tenth, do not use trailing zeros, use a leading zero if it applies)

A nurse is caring for a client who has active pulmonary tuberculosis (TB) and a new prescription for IV rifampin. The nurse should instruct the client that they should expect to experience which of the following manifestations while taking this medication?

The nurse receives an order to administer drug R 300 mg IVPB over one hour. Drug R is available as 300 mg in 100 mL NSS. The drip factor of the piggyback tubing is 15 gtts/mL. At what rate should the nurse regulate the IV flow?

The priority nursing intervention for a client who has a serum sodium level of 154 mEq/L would be:

A nurse is caring for a client prescribed drug N 235 mcg PO daily. Available is drug N PO 0.5 mg per 1 scored tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

The purpose of the nurse providing pre-operative teaching to clients undergoing surgery is to:

The nurse recognizes that the client is manifesting early signs of hypoxia with findings of:

The nurse recognizes that the primary physiologic problem affecting clients with emphysema is: