A patient with Chronic Obstructive Pulmonary Disease (COPD), who smokes two packs of cigarettes daily and is hospitalized due to a respiratory infection, reports difficulty managing respiratory distress at home when using the rescue inhaler.
Which statement from the patient suggests to the nurse that the inhaler is not being used correctly?

“I never use the inhaler unless I am really short of breath.”.

“I have a hard time inhaling and holding my breath after I squeeze the inhaler, but I do my best.”.

“After I squeeze the inhaler and swallow, I always feel a slight wave of nausea, but it goes away.”.

“I always shake the inhaler several times before I start.”.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Using the inhaler only when the patient is really short of breath is not an incorrect use of the inhaler. However, it might indicate that the patient is not managing their COPD effectively, as rescue inhalers like albuterol are meant to be used for quick relief of acute symptoms.

Choice B rationale

Having a hard time inhaling and holding the breath after squeezing the inhaler might suggest that the patient is not using the inhaler correctly. However, the patient’s statement that they “do their best” suggests that they are aware of the correct technique and are trying to follow it.

Choice C rationale

Swallowing after squeezing the inhaler is a clear indication of incorrect use. The medication from the inhaler is meant to be inhaled into the lungs, not swallowed. Swallowing the medication would lead to less of it reaching the lungs, reducing its effectiveness. The wave of nausea the patient experiences could be a side effect of swallowing the medication.

Choice D rationale

Shaking the inhaler several times before starting is actually part of the correct technique for using many types of inhalers.

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Correct Answer is C

Explanation

Choice A rationale

Canned chicken broth with barley is not the best choice for a patient with hypertension. Canned foods, including chicken broth, are often high in sodium, which can raise blood pressure.

Choice B rationale

Tomato juice and gluten-free crackers may seem like a healthy option, but tomato juice can be high in sodium. While gluten-free crackers can be part of a healthy diet, they don’t offer any specific benefits for controlling hypertension.

Choice C rationale

A plain baked sweet potato is an excellent choice for a patient with hypertension. Sweet potatoes are high in potassium, which can help lower blood pressure. They’re also a good source of fiber and are naturally low in sodium.

Choice D rationale

Dill pickles and black olives are both high in sodium, which can raise blood pressure. Therefore, they’re not a good choice for someone with hypertension.

A. Listen for bilateral breath sounds. B. Verify a capillary refill time of less than 3 seconds. C. Check that the ETT markings are between 22 and 26 cm at the teeth line. D. Observe for symmetrical chest movement. E. Arrange for a portable chest x-ray to confirm ETT location.

Correct Answer is ["A","C","D","E"]

Explanation

Choice A rationale

Listening for bilateral breath sounds is a common method to confirm the correct placement of the ETT1. When the ETT is correctly placed, breath sounds should be heard equally on both sides of the chest.

Choice B rationale

Verifying a capillary refill time of less than 3 seconds is not directly related to confirming the placement of an ETT. Capillary refill time is often used to assess peripheral circulation and hydration status, not airway management.

Choice C rationale

Checking that the ETT markings are between 22 and 26 cm at the teeth line is another method to confirm correct ETT placement. These markings help ensure that the ETT is not too far into the trachea, which could cause one lung to be ventilated more than the other.

Choice D rationale

Observing for symmetrical chest movement is a visual confirmation of correct ETT placement. When the ETT is correctly placed, both sides of the chest should rise and fall equally with each breath.

Choice E rationale

Arranging for a portable chest x-ray is considered the gold standard for confirming ETT location. It provides a visual confirmation that the ETT is in the trachea and not in the esophagus.

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Naxlex Comprehensive Predictor Exams

A nurse is providing dietary advice to a patient with hypertension.Which food item would be the best choice for the patient’s lunch?

Correct Answer is C

Explanation

A young adult is admitted to the emergency department after consuming an unknown quantity of drugs.The patient is unresponsive, and an endotracheal tube (ETT) has been inserted.What methods should the nurse use to confirm the correct placement of the ETT? Select all that apply.

Correct Answer is ["A","C","D","E"]

Explanation

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