The nurse provides care to a patient who is diagnosed with chronic obstructive pulmonary disease (COPD). The patient's pulse oximetry is 93% on room air with a current respiratory rate of 35 breaths per minute. The most recent chest x-ray indicates a flattened diaphragm with infiltrates. The patient is currently febrile with an increased number of white blood cells (WBCs) noted on the latest complete blood count (CBC). Which order does the nurse question for this patient based on the current data?

Chest physiotherapy (CPT) every 4 hours while awake

Oxygen therapy via nasal cannula at 3 to 4 L/min

Add humidification to the oxygen source

Raise the head of the patient's bed

Answer and Explanation

The Correct Answer is A

A. Chest physiotherapy (CPT) every 4 hours while awake. CPT is used to mobilize secretions but may be too aggressive for a patient with infiltrates and respiratory distress, as it can increase fatigue and worsen respiratory status.

B. Oxygen therapy via nasal cannula at 3 to 4 L/min. Low-flow oxygen therapy is often used in COPD to prevent hypoxemia while avoiding CO₂ retention.

C. Add humidification to the oxygen source. Humidified oxygen helps prevent airway dryness and improves secretion clearance, which is beneficial for COPD patients.

D. Raise the head of the patient's bed. Elevating the head of the bed promotes lung expansion and improves oxygenation, making this an appropriate intervention.

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Correct Answer is D

Explanation

A. Ensure an NPO status is maintained for the length of the prescribed treatment: While some ventilated patients are NPO, others receive enteral feeding. NPO status alone does not prevent aspiration.

B. Perform chest physiotherapy as prescribed by the practitioner: Chest physiotherapy helps clear secretions but does not directly reduce aspiration risk.

C. Limit each suctioning event to no more than 10 seconds: While limiting suction time is important to avoid hypoxia, it does not directly prevent aspiration.

D. Elevate the head of the bed between 30 to 45 degrees: Keeping the head of the bed elevated reduces the risk of aspiration, partic

A. A client who is taking a thiazide diuretic B. A client who has salicylate intoxication C. A client who has diarrhea D. A client who is vomiting

Correct Answer is C

Explanation

A. A client who is taking a thiazide diuretic: Thiazide diuretics promote loss of potassium and hydrogen ions, leading to metabolic alkalosis rather than acidosis.

B. A client who has salicylate intoxication: Early salicylate toxicity causes respiratory alkalosis, though severe cases can progress to metabolic acidosis.

C. A client who has diarrhea: Chronic diarrhea leads to excessive bicarbonate loss, resulting in metabolic acidosis.

D. A client who is vomiting: Vomiting leads to loss of stomach acid (HCl), which causes metabolic alkalosis, not acidosis.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse provides care to a patient who is mechanically ventilated. Which nursing action is most effective in decreasing the risk for aspiration?

Correct Answer is D

Explanation

A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that which of the following clients is at risk for metabolic acidosis?

Correct Answer is C

Explanation

A nurse is caring for a client who is exhibiting a depressed mood one week before the start of their menstrual cycle. The nurse should identify that the client is exhibiting manifestations consistent with which of the following disorders?

A nurse is caring for a client who has returned to the unit following a surgical procedure. The client's oxygen saturation is 85%. Which of the following actions should the nurse take first?

What is a common side effect of antipsychotics?

The nurse is providing education to a patient regarding the use of an incentive spirometer. Which patient statement requires further education?

Which client statement is evidence of the etiology of major depressive disorder from a genetic perspective?

When assessing a patient taking stimulant medications, the nurse should monitor for which of the following?

A client has a diagnosis of risk for suicide r/t a past attempt. Which of the following outcome should the nurse prioritize?