A nurse is providing preoperative teaching about using an incentive spirometer for a client. Which of the following instructions should the nurse include?

"Place the head of the bed flat before using the incentive spirometer."

"Hold your breath for 2 to 3 seconds when using the incentive spirometer."

"Use the incentive spirometer every 3 hours while awake."

"Breathe in through your nose when using the incentive spirometer."

Answer and Explanation

The Correct Answer is B

A. "Place the head of the bed flat before using the incentive spirometer." The client should be in a semi-Fowler’s or high-Fowler’s position (sitting upright) to maximize lung expansion.
B. "Hold your breath for 2 to 3 seconds when using the incentive spirometer." Holding the breath allows for maximum lung expansion and helps prevent atelectasis (lung collapse).
C. "Use the incentive spirometer every 3 hours while awake." The incentive spirometer should be used every 1 to 2 hours while awake to promote lung expansion and prevent complications such as pneumonia.
D. "Breathe in through your nose when using the incentive spirometer." The client should inhale deeply through the mouth, not the nose, to ensure proper lung inflation.

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Correct Answer is ["A","B","C"]

Explanation

A. Positive Trousseau's sign: A positive Trousseau’s sign (carpal spasm induced by inflating a blood pressure cuff) is a classic indicator of hypocalcemia due to increased neuromuscular excitability.
B. Muscle cramps: Hypocalcemia leads to increased nerve excitability, causing muscle cramps, spasms, and tetany.
C. Tingling sensation around the lips: This is a common early sign of hypocalcemia, known as perioral paresthesia, due to increased nerve excitability.
D. Negative Chvostek's sign: A client with hypocalcemia would have a positive Chvostek’s sign, which is facial twitching when the facial nerve is tapped.
E. Abdominal distention: Hypocalcemia is more associated with diarrhea and hyperactive bowel sounds, not abdominal distention, which is more typical of hypokalemia.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

The client is at risk for developing deep vein thrombosis (DVT) due to their immobility.

Rationale:

Swelling and tenderness in the calf are key signs of DVT, which is a common complication of immobility after a stroke.
Immobility leads to venous stasis, increasing the risk of clot formation.

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A nurse is providing preoperative teaching about using an incentive spirometer for a client. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has hypocalcemia. Which of the following findings should the nurse expect? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

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Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Explanation

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