A client with pulmonary embolism is experiencing severe shortness of breath. Which nursing intervention takes priority in this situation?
Administering pain medication
Initiating anticoagulant therapy
Providing supplemental oxygen
Encouraging ambulation
The Correct Answer is C
A) Incorrect. While pain management is important, providing supplemental oxygen to address severe shortness of breath takes priority.
B) Incorrect. Initiating anticoagulant therapy is essential but may take some time to have an effect. Oxygen therapy should be provided immediately to address the client's oxygenation.
C) Correct. Providing supplemental oxygen is the priority intervention for a client with severe
shortness of breath to ensure adequate oxygenation.
D) Incorrect. Encouraging ambulation is not appropriate in a client with severe shortness of breath. Stabilizing the client's oxygenation and condition is the immediate concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) Incorrect. An echocardiogram does not visualize blood clots in the pulmonary arteries; it focuses on assessing heart function and structure.
B) Correct. An echocardiogram provides valuable information about heart valve function and heart structure, helping assess the impact of a pulmonary embolism on the heart.
C) Incorrect. Measurement of arterial blood gases (ABGs) is typically performed through blood sampling, not with an echocardiogram.
D) Incorrect. Echocardiograms do not evaluate lung function and ventilation; they primarily assess cardiac function.
Correct Answer is D
Explanation
A) Incorrect. Wheezing is a high-pitched whistling sound that occurs during expiration and is not associated with crackling sounds.
B) Incorrect. Rhonchi are continuous low-pitched sounds heard during both inspiration and expiration, usually due to airway obstruction.
C) Incorrect. Stridor is a high-pitched, crowing sound that occurs during inspiration and suggests upper airway obstruction.
D) Correct. Rales, also known as crackles, are crackling or popping sounds heard during inspiration and can be indicative of fluid or inflammation in the lungs, which can occur with pulmonary embolism.
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