A nurse is caring for a client who is receiving positive-pressure mechanical ventilation. Which of the following interventions should the nurse implement to prevent complications? (Select all that apply.)

Administer pantoprazole as prescribed.

Reposition the endotracheal tube to the opposite side of the mouth daily.

Verify the prescribed ventilator settings daily.

Elevate the head of the bed to at least 30°.

Apply restraints if the client becomes agitated.

Answer and Explanation

Correct Answer : A,B,D

Correct answers: A, B ,D

A. Stress ulcer prophylaxis (e.g., a PPI) is indicated for critically ill, ventilated patients to prevent GI bleeding from stress-related mucosal damage.

B. Rotating the tube and tape from side to side prevents pressure necrosis of the lips and oral mucosa.

D. Semi-Fowler’s positioning (≥30°) reduces aspiration risk and helps prevent ventilator-associated pneumonia.

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Correct Answer is D

Explanation

This is because according to the rule of nines, each arm accounts for 9 percent and each leg accounts for 18 percent of the TBSA. Therefore, burns on both arms and both legs equal (9+9+18+18) =54%.

A. It is primarily transmitted through casual contact. B. It is primarily transmitted through mosquitoes. C. It is primarily transmitted through direct contact with infected body fluids. D. It is primarily transmitted through accidental puncture wounds.

Correct Answer is C

Explanation

This is because HIV is a virus that infects certain cells of the immune system, such as CD4 cells or T cells. HIV can be found in blood, semen, vaginal fluid, breast milk, and other body fluids that contain blood. HIV can be transmitted through sexual contact, sharing needles or syringes, mother-to-child transmission during pregnancy or breastfeeding, or occupational exposure to blood or body fluids.

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A nurse is caring for a client who is receiving positive-pressure mechanical ventilation. Which of the following interventions should the nurse implement to prevent complications? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an emergency department is caring for a client who has burns on the front and back of both his legs and arms. Using the rule of nines the nurse should document burns to which percentage of the client's total body surface area (TBSA)?

Correct Answer is D

Explanation

A nurse is planning a presentation about HIV for a church-based group. Which of the following information about HIV transmission should the nurse include?

Correct Answer is C

Explanation

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