The nurse is caring for a patient who has been trying to quit smoking. The patient has been smoke free for 2 weeks but had two cigarettes last night and at least two this morning, what should the nurse anticipate?

The patient must pick up the attempt right where the patient left left off

The patient will need to adapt a new lifestyle for change to be effective

The patient does not want and will never quit smoking

The patient will return to the contemplation or precontemplation phase

Answer and Explanation

The Correct Answer is D

A) The patient must pick up the attempt right where the patient left off: Quitting smoking is a process, and a setback, such as smoking a few cigarettes, does not mean the patient must pick up where they left off as if nothing happened. The patient may need to reassess their goals, identify triggers, and modify their approach, but this setback does not mean they should immediately resume from the same spot. It’s about recognizing the challenge and continuing forward, not picking up as if no progress was made.

B) The patient will need to adapt a new lifestyle for change to be effective: While adapting to a new lifestyle is necessary for long-term success in quitting smoking, this answer overemphasizes a sudden, drastic shift. In fact, the patient may need more time in the stages of change to incorporate healthier behaviors and coping mechanisms. A lapse doesn’t automatically mean the patient has successfully adapted a new lifestyle, but it may highlight areas that need further focus.

C) The patient does not want and will never quit smoking: This assumption is not accurate. A lapse in smoking behavior does not mean the patient does not want to quit. Many individuals trying to quit smoking experience setbacks or relapses, but that does not negate their desire or ability to quit in the future. It's important to avoid labeling the patient as unwilling or incapable based on one setback.
D) The patient will return to the contemplation or precontemplation phase: This is the most accurate response. A patient who has been smoke-free but then relapses may return to the contemplation phase (where they begin to think about quitting again) or the precontemplation phase (where they are not yet actively considering quitting). The relapse does not erase the progress made but may lead to reevaluating the readiness to quit and reengaging in the quitting process with more awareness of the challenges ahead.

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Correct Answer is A

Explanation

A) Auscultate the entire lung region to assess lung sounds: This is the most comprehensive action. To properly assess for respiratory complications related to immobility, the nurse should auscultate all lung fields (anterior, posterior, and lateral) to detect any abnormal lung sounds such as crackles, wheezes, or decreased breath sounds. This thorough assessment helps to identify early signs of respiratory compromise, such as atelectasis or pneumonia, which are common complications of immobility.
B) Assess the patient at least every 4 hours: While regular assessment is important, the frequency of assessment should be tailored to the patient’s condition and risk factors. In critically ill or immobile patients, more frequent assessments (every 1-2 hours) may be necessary to detect changes in respiratory status early. A minimum of 4 hours may be too long between assessments for patients at risk for respiratory complications.

C) Inspect chest wall movements primarily during the expiratory cycle: The nurse should assess both the inspiratory and expiratory phases of chest wall movement, not focus solely on expiration. Inspecting both phases allows the nurse to evaluate whether the patient is having difficulty with inspiration or expiration, both of which are important indicators of respiratory function. Focusing only on expiration might miss other critical issues like shallow or labored breathing during inspiration.

D) Focus auscultation on the upper lung fields: While it is important to auscultate the upper lung fields, respiratory complications related to immobility, such as atelectasis, are more commonly observed in the lower lung fields due to gravity. Auscultating only the upper lung fields could miss abnormalities in the lower parts of the lungs, where secretions may accumulate more easily in immobile patients. Full lung auscultation is necessary for an accurate assessment.

A. A patient with a stage IV pressure ulcer B. A patient with neck surgery C. A patient with hypostatic pneumonia D. A patient with a total knee replacement

Correct Answer is B

Explanation

A) A patient with a stage IV pressure ulcer: While logrolling is important for patients with pressure ulcers to prevent further skin damage and to ensure proper positioning, it is not the most common intervention for a patient with a stage IV pressure ulcer. For such patients, the primary focus is on wound care, pain management, and preventing further pressure on the affected area, rather than using logrolling as a primary method of movement.

B) A patient with neck surgery: Logrolling is most commonly used for patients with spinal injuries or those who have had neck surgery. The goal is to maintain the alignment of the spine during movement to avoid causing further injury or strain. This technique helps prevent flexion or twisting of the neck and spine, which is critical for the safety of patients recovering from neck surgery.

C) A patient with hypostatic pneumonia: Hypostatic pneumonia, a type of lung infection due to immobility, is more commonly managed through respiratory interventions like deep breathing exercises, chest physiotherapy, and turning the patient to prevent secretion buildup in the lungs. While positioning is important, logrolling is not specifically indicated for this condition unless there is a concurrent spinal injury or surgery.

D) A patient with a total knee replacement: Logrolling is not typically required for patients with total knee replacements. The patient may need to be positioned carefully to protect the knee joint, but the primary focus in their care is on joint mobility, pain management, and preventing complications related to immobility, rather than performing logrolling to protect the spine or neck.

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The nurse is caring for a patient who has been trying to quit smoking. The patient has been smoke free for 2 weeks but had two cigarettes last night and at least two this morning, what should the nurse anticipate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing the patient for respiratory complications of immobility. Which action will the nurse take assessing, the respiratory system?

Correct Answer is A

Explanation

A nurse is supervising the logrolling of a patient. To which patient is the nurse most likely providing care?

Correct Answer is B

Explanation

A nurse is developing a plan of care for an older adult who is at risk for falls. Which of the following actions should the nurse plan to include in the plan? (Select all that apply)

A nurse is adhering to standard precautions while caring for a group of clients. For which of the following tasks should the nurse wear protective eye equipment? (Select all that apply.)

A nurse is assessing the body alignment of a standing patient. Which finding will the nurse report as normal?

A nurse is teaching a health promotion class about isotonic exercises. Which types of exercises will the nurse give as examples?

A nurse is assisting a client during ambulation when the client begins to fall. Which of the following actions should the nurse take?

A nurse reviews an immobilized patient's laboratory results and discovers that his/her calcium lab values are abnormally high (Hypercalcemia). Which condition will the nurse monitor for most closely in this patient?