The nurse assists a patient into which position in preparation for a diagnostic thoracentesis?

Sitting upright with elbows on an over-bed table and feet supported

Sitting in bed with knees slightly flex and feet flexed

Lying flat in the fetal position on the unaffected side

Lying flat on the unaffected side with knees slightly flexed

Answer and Explanation

The Correct Answer is A

A. The optimal position for a thoracentesis is sitting upright with the patient leaning forward slightly, with elbows resting on an over-bed table to help expose the pleural space for access. This position allows gravity to pull the lungs downward and facilitates easier access to the pleural cavity.
B. Sitting in bed with knees slightly flexed and feet flexed is not the best position for thoracentesis. This position might limit the ability to properly expose the thoracic cavity for the procedure.
C. Lying flat in the fetal position on the unaffected side would not allow for effective drainage or access to the pleural space and is not ideal for thoracentesis.
D. Lying flat on the unaffected side with knees slightly flexed is not ideal because it does not provide optimal positioning for the procedure. The upright position is preferred for thoracentesis to facilitate easy access to the pleural space.

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Correct Answer is C

Explanation

A. Increase carbohydrate intake.: This is incorrect. Cushing’s disease is characterized by excessive cortisol, which can lead to increased blood glucose levels, making carbohydrate intake less desirable. Clients with Cushing's disease often need to manage their blood sugar levels, so they should not increase carbohydrates indiscriminately.
B. Limit intake of potassium-rich foods.: This is incorrect. In Cushing’s disease, elevated cortisol levels can lead to potassium depletion, so clients should actually increase their intake of potassium-rich foods to help counteract the effects of low potassium, not limit them.
C. Restrict sodium intake.: This is correct. Cushing’s disease often results in fluid retention and hypertension due to increased cortisol and aldosterone levels. Restricting sodium helps manage these symptoms and reduces the risk of complications such as edema and high blood pressure.
D. Decrease protein intake.: This is incorrect. While protein breakdown is a feature of Cushing's disease, protein intake should not necessarily be decreased. Adequate protein intake is important to prevent muscle wasting, a common issue in clients with Cushing’s disease.

A. Hirsutism B. Hyperpigmentation C. Purple striations D. Intention tremors

Correct Answer is B

Explanation

A. Hirsutism, or excessive hair growth, is more commonly associated with conditions such as polycystic ovary syndrome (PCOS) or Cushing’s syndrome, rather than Addison’s disease.
B. Hyperpigmentation is a characteristic sign of Addison’s disease. Due to insufficient cortisol production in the adrenal glands, there is an increase in melanocyte-stimulating hormone (MSH), which leads to darkening of the skin, particularly in areas exposed to friction like elbows, knees, and the face.
C. Purple striations are a common finding in Cushing’s syndrome, which results from excessive cortisol production. They are not typically seen in Addison's disease.
D. Intention tremors are more commonly associated with neurological conditions, such as Parkinson’s disease, rather than Addison’s disease, which primarily affects the adrenal glands.

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The nurse assists a patient into which position in preparation for a diagnostic thoracentesis?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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