A nurse is assessing a client following the insertion of a central venous catheter.
Which of the following findings indicates a pneumothorax?
Distended neck veins.
Itching over the incision.
Irregular heart rate.
Diminished breath sounds.
The Correct Answer is D
A pneumothorax is a collapsed lung that occurs when air leaks into the space between the lung and the chest wall.
This can cause diminished breath sounds on the affected side. Distended neck veins are not a symptom of pneumothorax.
B) Itching over the incision is not a symptom of pneumothorax.
C) Irregular heart rate is not a symptom of pneumothorax.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The nurse should place the client in a position with their feet elevated.
This position helps to increase blood flow to the vital organs and can help improve the client’s blood pressure.
Choice A is not the answer because the Reverse Trendelenburg position does not help improve blood flow to vital organs.
Choice B is not the answer because the side-lying position does not help improve blood flow to vital organs.
Choice D is not the answer because High-Fowler’s position does not help improve blood flow to vital organs.
Correct Answer is A
Explanation
The nurse should instruct the client to wash their perineal area two times each day with antimicrobial soap.
This is important because chemotherapy can weaken the immune system, making the client more susceptible to infections.
Choice B is wrong because washing a toothbrush in a dishwasher once a month is not an effective way to prevent infection.
Choice C is wrong because changing a pet’s litter box daily could expose the client to harmful bacteria and should be avoided.
Choice D is wrong because changing the water in a drinking glass every 4 hours is not necessary for preventing infection.
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