A nurse is caring for a client diagnosed with pneumonia who has labored breathing and copious tracheobronchial secretions.

What priority action should the nurse encourage with the client?

Limit oral fluids to minimize labored breathing.

Lie in a low Fowler’s position to promote lung expansion.

Perform hourly incentive spirometry to inflate lungs and mobilize secretions.

Perform pursed lip breathing to expel trapped carbon dioxide from the alveoli.

Answer and Explanation

The Correct Answer is C

Choice A rationale
Limiting oral fluids is not the best action for a client with pneumonia and copious tracheobronchial secretions. Adequate hydration can actually help thin and loosen pulmonary secretions, making them easier to expel.
Choice B rationale
While lying in a low Fowler’s position can aid in lung expansion, it is not the priority action in this case. The client has copious tracheobronchial secretions, and the most effective way to mobilize these secretions is through incentive spirometry.
Choice C rationale
Performing hourly incentive spirometry can help inflate the lungs and mobilize secretions, which is particularly beneficial for a client with pneumonia who has copious tracheobronchial secretions. This is the priority action as it directly addresses the client’s issue of labored breathing due to excessive secretions.
Choice D rationale
Pursed lip breathing is a technique used primarily to slow the pace of breathing and can help maintain open airways longer. However, it is not the most effective method for mobilizing tracheobronchial secretions.

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Correct Answer is D

Explanation

Choice A rationale
Performing an opening move is an initial step in the negotiation process where each party presents their initial demands or offers. This is not the step the nurse manager is using in this scenario.
Choice B rationale
Continuing the negotiation involves ongoing discussions and adjustments to reach a mutually beneficial agreement. This is not the step the nurse manager is using in this scenario.
Choice C rationale
Clarifying the problem involves understanding and defining the issues at hand. While this is an important step in the negotiation process, it is not the step the nurse manager is using in this scenario.
Choice D rationale
Setting ground rules involves establishing the guidelines for how the negotiation will be conducted. In this scenario, the nurse manager is setting ground rules by inviting the staff to each take a turn speaking and requesting that everyone listen respectfully and refrain from making personal or professional comments about one another.

A. “As your appetite returns, your sense of smell will also return.”. B. “Your body will slowly develop an ability to smell through your stoma.”. C. “Your sense of smell will gradually return after several months.”. D. “Breathing through a stoma has altered your sense of smell.”.

Correct Answer is D

Explanation

Choice A rationale
While it’s true that appetite and sense of smell are closely linked, the return of appetite does not necessarily mean the return of the sense of smell, especially after a total laryngectomy.
Choice B rationale
The body does not develop an ability to smell through the stoma. The sense of smell is primarily mediated by the olfactory nerve (Cranial Nerve I), which is located in the upper part of the nasal cavity.
Choice C rationale
The sense of smell does not typically return after several months following a total laryngectomy. This is because the surgery involves removal of the larynx and separation of the airway from the mouth, nose and throat.
Choice D rationale
Breathing through a stoma after a total laryngectomy does alter the sense of smell. This is because the nose and mouth are bypassed during breathing, and these are the primary routes for smell.

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A nurse is caring for a client diagnosed with pneumonia who has labored breathing and copious tracheobronchial secretions. What priority action should the nurse encourage with the client?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is caring for a patient who reports experiencing an alteration in sense of smell following surgery for a total laryngectomy. The nurse should address the patient’s concern through which of the following responses?

Correct Answer is D

Explanation

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A nurse is caring for a client diagnosed with pneumonia who has labored breathing and copious tracheobronchial secretions.

What priority action should the nurse encourage with the client?