A nurse is reinforcing teaching with a client who has pleurisy. Which of the following statements by the client indicates an understanding of the teaching?

“I should expect to develop a fever and a productive cough."

"This condition is chronic."

"I should lie on the affected side."

"I should take shallow breaths while I have pleurisy."

Answer and Explanation

The Correct Answer is C

A.   Pleurisy can be associated with fever due to inflammation, but a productive cough is not a defining characteristic of pleurisy. Pleurisy is often marked by sharp chest pain, especially during breathing or coughing, rather than a productive cough.

B.   Pleurisy is typically an acute condition, often resulting from an infection or other inflammatory processes, such as pneumonia or autoimmune diseases. It is not classified as chronic unless there is a recurring underlying issue.
C.   Lying on the affected side can help alleviate pain because it reduces movement of the pleura (the membranes surrounding the lungs) and may provide comfort. This demonstrates an understanding of the comfort measures that can be taken to manage pleuritic pain.
D.   Patients with pleurisy should be encouraged to take deep breaths, as shallow breathing can lead to atelectasis (collapse of the lung) due to reduced lung expansion.

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Correct Answer is A

Explanation

A. Pulmonary embolism can lead to hypoxemia due to impaired blood flow in the lungs. Administering oxygen helps to improve oxygenation and is often one of the first steps in managing a PE.
B. This intervention is not a priority in the acute management of a PE. While fluid resuscitation may be necessary in certain scenarios, it is not the immediate focus. The main concern in a PE is addressing the oxygenation and potential hemodynamic instability.
C. This intervention may be necessary for pain management and to reduce anxiety, but it is not the priority. Morphine can help reduce the workload on the heart, but it should not replace the more immediate interventions focused on oxygenation and stabilization.
D. This is also a high priority intervention. Patients with a pulmonary embolism are at risk for arrhythmias and other cardiac complications, so continuous cardiac monitoring is essential. However, while this is important, it often follows the initiation of oxygen therapy.

A. Providing the client with a communication board B. Suctioning the airway as needed C. Administering continuous feeding through a nasogastric tube D. Applying thigh-high antiembolism stockings

Correct Answer is B

Explanation

A. Communication is crucial for clients on mechanical ventilation, especially if they are awake and able to use a communication board. However, addressing life-threatening issues takes precedence over communication aids.
B. Maintaining a patent airway is critical for a client on mechanical ventilation. If the client is unable to clear secretions or if there are signs of airway obstruction (like decreased breath sounds or increased respiratory effort), suctioning is necessary to prevent complications such as hypoxia or ventilator- associated pneumonia.
C. This option is important for nutritional support, but it is not the immediate priority. While providing nutrition is essential for recovery and maintaining the client's overall health, ensuring a clear and open airway is crucial for the client's immediate safety.
D. This option is also important for preventing deep vein thrombosis (DVT) in clients who are immobile or on long-term ventilation. However, like the previous options, it is not as critical as ensuring airway patency.

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A nurse is reinforcing teaching with a client who has pleurisy. Which of the following statements by the client indicates an understanding of the teaching?

Nursing Test Bank

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