A nurse is planning postoperative care for a client who is having a thoracotomy with a chest tube placement. Which of the following pieces of equipment should the nurse plan to have at the client's bedside?

Wire cutters

Tracheostomy tray

Padded clamp

Sand bag

Answer and Explanation

The Correct Answer is C

A. Wire cutters – These are used in clients with wired jaws, not for chest tube management.

B. Tracheostomy tray – This is necessary for airway emergencies but is not specific to chest tube management.

C. Padded clamp – This is the correct answer because a padded clamp is used to assess for air leaks, check chest tube patency, or temporarily clamp the tube if needed during troubleshooting or before removal.

D. Sand bag – A sandbag is not necessary for a client with a chest tube; it is more commonly used for stabilizing orthopedic injuries.

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Correct Answer is A

Explanation

A. Irritability – This is the expected finding. Newborns exposed to cocaine in utero often exhibit irritability, hypertonia, tremors, and a high-pitched cry due to withdrawal symptoms and central nervous system excitability.

B. Increased head circumference – Cocaine use is associated with intrauterine growth restriction (IUGR), leading to smaller head circumferences rather than increased head size.

C. Hypotonicity – Cocaine-exposed newborns typically exhibit hypertonicity (increased muscle tone) rather than hypotonia.

D. Decreased auditory startle response – These newborns usually have an exaggerated Moro (startle) reflex rather than a decreased response.

A. Fold the stockings at the top if they are too long. B. Remove the stockings every 24 hr. C. Massage the legs before applying the stockings. D. Measure the legs with a tape measure to determine stocking size.

Correct Answer is D

Explanation

A. Fold the stockings at the top if they are too long – Folding the stockings can create a tourniquet effect, restricting circulation and increasing the risk of complications.

B. Remove the stockings every 24 hr – Antiembolitic stockings should be removed at least every 8 hr to assess skin integrity and circulation, not just once per day.

C. Massage the legs before applying the stockings – Massaging the legs is contraindicated in clients with DVT because it can dislodge a clot, leading to a pulmonary embolism.

D. Measure the legs with a tape measure to determine stocking size – This is the correct action because improper fit can reduce effectiveness or impair circulation. The nurse should measure the client’s legs and select the appropriate size for optimal compression.

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A nurse is planning postoperative care for a client who is having a thoracotomy with a chest tube placement. Which of the following pieces of equipment should the nurse plan to have at the client's bedside?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is performing a physical assessment of a newborn whose mother used cocaine throughout the pregnancy. Which of the following findings should the nurse expect?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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