Exhibits

What is the most appropriate initial management for this patient?

Apply positive pressure ventilation and provide supportive care with pain management.

Perform needle decompression of the pleural space followed by chest tube insertion.

Administer intravenous antibiotics and arrange for an elective surgical repair.

Provide high-flow oxygen and intubate the patient for mechanical ventilation.

Answer and Explanation

The Correct Answer is B

A. Apply positive pressure ventilation and provide supportive care with pain management: While supportive care is important, positive pressure ventilation may not be sufficient to address the underlying issue, which is likely a pneumothorax or hemothorax.
B. Perform needle decompression of the pleural space followed by chest tube insertion: This is the most appropriate initial management for a patient with paradoxical chest wall movement, which is a sign of flail chest and likely pneumothorax. Needle decompression can relieve pressure in the pleural space, and chest tube insertion can help drain any fluid or air that has accumulated.
C. Administer intravenous antibiotics and arrange for an elective surgical repair: While infection may be a concern, it is not the most immediate priority in this case. The patient's respiratory distress needs to be addressed first.
D. Provide high-flow oxygen and intubate the patient for mechanical ventilation: While oxygen therapy may be necessary, intubation should be considered as a last resort if other measures fail to improve oxygenation. In this case, needle decompression and chest tube insertion are more likely to be effective in improving respiratory function.

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Correct Answer is C

Explanation

A. The client is producing large amounts of clear, watery nasal discharge and experiencing postnasal drip: Clear, watery nasal discharge is more indicative of allergic rhinitis rather than sinusitis, which typically presents with thicker, purulent discharge.

B. The client has a history of both tension and vascular headaches and takes prescription migraine medication as needed: While headaches can accompany sinusitis, this option does not directly address symptoms specific to sinusitis, such as nasal congestion or facial pressure.

C. The client has nasal congestion that does not significantly improve with over-the-counter decongestants or antihistamines: Persistent nasal congestion despite the use of decongestants or antihistamines is a common symptom of sinusitis, indicating that the source of the problem may be inflammation or infection in the sinuses.

D.The client regularly uses saline-based nasal washes and a humidifier to clean and moisturize their sinuses: Regular use of these measures suggests the client is taking preventive care of their sinuses but does not necessarily indicate sinusitis.

A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

Correct Answer is B

Explanation

A. Respiratory acidosis occurs due to hypoventilation, resulting in carbon dioxide retention. This condition is characterized by slow, shallow breathing and confusion, which is not consistent with the client's rapid respiratory rate of 30/min.
B. Respiratory alkalosis is typically caused by hyperventilation, where excessive breathing leads to a decrease in carbon dioxide levels. The client's symptoms of high anxiety and rapid, shallow respirations are indicative of hyperventilation, making respiratory alkalosis the most likely diagnosis.
C. Metabolic acidosis is characterized by deep, rapid breathing (Kussmaul respirations) as the body attempts to expel excess acid. The client's shallow respirations are inconsistent with the breathing pattern seen in metabolic acidosis.
D. Metabolic alkalosis usually presents with symptoms such as dizziness and tingling, often with compensatory slow respirations. The rapid respiratory rate in this case does not suggest metabolic alkalosis, making this option unlikely.

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Exhibits What is the most appropriate initial management for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care to a client who reports facial pain, including dental pain in the upper teeth. Which of the following additional symptoms would lead the nurse to suspect sinusitis as the source of the pain?

Correct Answer is C

Explanation

A nurse is caring for a client in the emergency department (ED) who has high anxiety and shallow respirations at a rate of 30/min. Which of the following acid-base disturbances is the client most likely experiencing?

Correct Answer is B

Explanation

A nurse is collecting data for a client who has tension pneumothorax. Which of the following findings should the nurse expect following tracheal deviation?

A nurse is collecting data for a client who has acute respiratory distress syndrome (ARDS). Which of the following findings should the nurse expect?

A nurse is reinforcing discharge education to a client who has hypokalemia. Which of the following suggestions should be included in the teaching plan?

A nurse is caring for a client who is postoperative following a tracheostomy and has copious and tenacious secretions. Which of the following is an acceptable method for the nurse to use to thin this client's secretions?

Exhibits Which of the following is the most appropriate treatment strategy for this patient, who is likely experiencing allergic rhinitis?

A nurse is collecting data from a client who is having an acute asthma exacerbation. When auscultating the client's chest, the nurse should expect to hear which of the following sounds?

A nurse is assisting with the care of a client who has chronic obstructive pulmonary disease (COPD) and is short of breath. When reviewing the client's arterial blood gases (ABGs), which of the following conditions should the nurse anticipate the client to be experiencing?

A nurse is collecting data from a client who has a respiratory disorder and displays manifestations of hypoxia. Which of the following findings should the nurse expect?

Exhibits

What is the most appropriate initial management for this patient?