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. Bradypnea B. Cyanosis C. Pallor D. Bradycardia

Correct Answer is B

Explanation

A. Bradypnea, or abnormally slow breathing, is not typically associated with hypoxia. Hypoxia usually triggers an increase in respiratory rate (tachypnea) as the body attempts to take in more oxygen to meet its needs.
B. Cyanosis, a bluish discoloration of the skin and mucous membranes, is a key sign of hypoxia. It occurs when there is insufficient oxygen in the blood, leading to a darker color of deoxygenated hemoglobin. Cyanosis is most commonly observed in the lips, fingertips, and toes.
C. Pallor, or paleness of the skin, can occur in various conditions but is not specific to hypoxia. It is more commonly associated with anemia or shock rather than low oxygen levels in the blood.
D. Bradycardia, or a slower-than-normal heart rate, is not typically a manifestation of hypoxia. Instead, hypoxia often causes tachycardia as the body attempts to increase oxygen delivery to tissues by pumping blood more quickly.

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

Correct Answer is B

Explanation

A nurse is collecting data on a client who has pneumonia. Which of the following findings should the nurse expect?

A nurse is assisting with the plan of care for a client who has pneumonia and requires chest percussion, vibration, and postural drainage. Which of the following actions should the nurse plan to complete first?

A nurse is reinforcing discharge instructions for a client who has asthma and is about to start using beclomethasone MDI. For which of the following findings should the nurse instruct the client to monitor and report to the provider as an adverse effect of the medication?

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 preparations for administering intravenous potassium replacement supplements to a client who has a potassium level of 2.5 mEq/L. Which of the following actions should the nurse plan to include? (Select all that apply.)

A nurse at a long-term care facility is reinforcing teaching with a newly hired nurse about the care of clients who are receiving mechanical ventilation. Which of the following information should the nurse include?

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 from a client who has seasonal allergies and is taking an antihistamine. Which of the following findings is an adverse effect of this type of medication?

Exhibits

What is the most appropriate initial management for this patient?