In assisting a dyspneic client with morning care, which action by the practical nurse (PN) is most important?

Schedule frequent rest periods during care.

Assist the client to a chair before making the bed.

Ask the client about his usual morning routine.

Encourage the client to participate in the care.

Answer and Explanation

The Correct Answer is A

A. Schedule frequent rest periods during care: Allowing frequent rest periods is crucial for a dyspneic client to prevent exhaustion and worsening of respiratory distress. Spacing activities conserves energy, improves oxygenation, and reduces the workload on the heart and lungs during basic care tasks.
B. Assist the client to a chair before making the bed: Moving the client to a chair may help with bed-making logistics but does not directly address the client’s immediate respiratory needs. Prioritizing respiratory support over convenience is more important in dyspneic clients.
C. Ask the client about his usual morning routine: Understanding a client’s routine can help personalize care but is not the most critical action when dyspnea is present. Ensuring that the client can safely tolerate activities without respiratory compromise takes priority.
D. Encourage the client to participate in the care: Encouragement is helpful for promoting independence but must be balanced carefully. Pushing a dyspneic client to participate too much could lead to fatigue and exacerbate respiratory symptoms

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Correct Answer is C

Explanation

A. Bruising: Bruising is more commonly associated with platelet disorders or clotting deficiencies rather than low calcium levels. It does not directly relate to the neuromuscular symptoms caused by hypocalcemia.
B. Pallor: Pallor is often a sign of anemia or poor perfusion, not a specific indicator of low serum calcium levels. While important to observe, it is not the most relevant concern in hypocalcemia.
C. Tetany: Tetany, characterized by muscle cramps, spasms, and sometimes severe convulsions, is a classic symptom of hypocalcemia. Low calcium levels increase neuromuscular excitability, leading to these involuntary muscle contractions, which require immediate monitoring and intervention.
D. Jaundice: Jaundice reflects elevated bilirubin levels, typically related to liver dysfunction, not calcium imbalance. It would not be expected in a client primarily experiencing malabsorption-induced hypocalcemia.

A. Provide a Yankauer tip for oral suction. B. Swab the oral cavity with a washcloth. C. Support the head with a small pillow. D. Use oral swabs with normal saline.

Correct Answer is D

Explanation

A. Provide a Yankauer tip for oral suction: A Yankauer suction device is useful for clearing large amounts of oral secretions but is typically used when secretions are too excessive to manage with swabbing alone. In routine oral care for an unconscious client, gentle cleaning with swabs is safer and minimizes mucosal trauma.
B. Swab the oral cavity with a washcloth: Using a washcloth in an unconscious client's mouth can be unsafe because it is bulky, can cause trauma to delicate tissues, and increases the risk of aspiration if too much fluid or debris is present. Oral swabs are designed to be safer and more appropriate for this purpose.
C. Support the head with a small pillow: While supporting the head ensures comfort, it does not directly address the priority need of safely and thoroughly cleaning the oral cavity to maintain hygiene and prevent infection. Airway protection and thorough cleaning are the primary concerns during oral care.
D. Use oral swabs with normal saline: Using oral swabs moistened with normal saline is the best intervention because it gently cleanses the mucous membranes, maintains moisture, and reduces the risk of mucosal injury. Normal saline is safe and non-irritating, which is critical for unconscious clients at risk for aspiration and mucosal breakdown.

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In assisting a dyspneic client with morning care, which action by the practical nurse (PN) is most important?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with a malabsorption syndrome has a low serum calcium level. The practical nurse should monitor the client for which problem?

Correct Answer is C

Explanation

While providing oral care for a client who is unconscious, the practical nurse (PN) positions the client laterally and uses a basin to collect secretions. Which intervention is best for the PN to implement?

Correct Answer is D

Explanation

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The practical nurse (PN) is providing care for a client with a history of a stroke and who has aphasia. The client is exhibiting restlessness, shallow respirations and is clenching teeth. Which problem should the PN assess further?

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