A client with orthopnea expresses concern about the ability to "Get enough air" during a scheduled thoracentesis. On which information should the nurse's response be based?

Extra pillows can be used if needed to elevate the client's head.

The procedure is performed with the client in an upright position.

Orthopnea is frequently caused by a client's uncontrolled anxiety.

Thoracentesis is a brief procedure that has minimal discomfort.

Answer and Explanation

The Correct Answer is B

A. Extra pillows can be used if needed to elevate the client's head: While pillows may help relieve mild respiratory discomfort, they may not provide sufficient support for someone with orthopnea, especially during a procedure. Relying on pillows alone does not address the optimal positioning required during thoracentesis.

B. The procedure is performed with the client in an upright position: Thoracentesis is typically done with the client sitting upright and leaning slightly forward, which enhances lung expansion and helps alleviate orthopnea by reducing diaphragmatic pressure. This positioning not only facilitates needle access to the pleural space but also improves the client’s respiratory comfort.

C. Orthopnea is frequently caused by a client's uncontrolled anxiety: Orthopnea is a physiological symptom, usually related to heart or lung conditions, not psychological factors. Suggesting it's due to anxiety may invalidate the client’s experience and delay appropriate supportive interventions.

D. Thoracentesis is a brief procedure that has minimal discomfort: While generally true, this statement overlooks the client’s current concern about breathing difficulty. Focusing solely on procedural duration or discomfort doesn't address the anxiety and physical limitations imposed by orthopnea.

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Free Nursing Study Resources

Correct Answer is ["200"]

Explanation

Calculation:

Total volume to be infused = 100 mL

Infusion time in hours:

Infusion time (hours) = Infusion time (minutes) / 60 minutes/hour

= 30 minutes / 60 minutes/hour

= 0.5 hours

Calculate the infusion rate in mL/hour:

Infusion rate (mL/hour) = Total volume (mL) / Infusion time (hours)

= 100 mL / 0.5 hours

= 200 mL/hour

A. Central type obesity, with thin extremities. B. Visible swelling of the neck, with no pain. C. Warm, soft, moist, salmon colored skin. D. Husky voice and troubled by hoarseness.

Correct Answer is A

Explanation

A. Central type obesity, with thin extremities: This is a classic presentation of Cushing’s syndrome, resulting from prolonged exposure to high cortisol levels. Fat is redistributed to the trunk (trunkal obesity), face (moon face), and back of the neck (buffalo hump), while muscle wasting leads to thin arms and legs, reflecting catabolic effects on peripheral tissues.

B. Visible swelling of the neck, with no pain: This description more accurately reflects a goiter or thyroid enlargement, which is associated with thyroid disorders like hypothyroidism or Graves’ disease, not Cushing’s syndrome.

C. Warm, soft, moist, salmon colored skin: This description is not typical of Cushing's syndrome. In contrast, clients with Cushing’s syndrome often exhibit thin, fragile skin, easy bruising, and purple striae due to collagen breakdown.

D. Husky voice and troubled by hoarseness: These symptoms may indicate laryngeal involvement or hypothyroidism affecting the vocal cords, not hypercortisolism. Cushing’s syndrome typically affects fat distribution, skin integrity, and glucose metabolism, not vocal quality.

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A client with orthopnea expresses concern about the ability to "Get enough air" during a scheduled thoracentesis. On which information should the nurse's response be based?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["200"]

Explanation

Which findings during the admission assessment should the nurse document that are related to a client diagnosed with Cushing's syndrome?

Correct Answer is A

Explanation

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