The practical nurse (PN) is assisting a client to cough and deep breathe following surgery. To facilitate effective coughing, the PN should assist the client to assume which position?
Sitting on side of bed with feet flat on the floor.
Left-lateral with pillow between flexed knees.
Lying prone with the head turned to one side.
Leaning forward over the bedside table
The Correct Answer is A
A. Sitting on side of bed with feet flat on the floor: Sitting upright with feet supported allows maximum lung expansion and diaphragmatic movement, facilitating effective deep breathing and coughing. This position also promotes airway clearance and reduces the risk of postoperative complications like atelectasis.
B. Left-lateral with pillow between flexed knees: Lateral positioning may be comfortable for rest but does not optimize lung expansion or coughing efficiency. It can limit diaphragmatic movement and the force generated during a cough.
C. Lying prone with the head turned to one side: The prone position restricts lung expansion and is uncomfortable for many postoperative clients. It is not conducive to effective coughing or deep breathing exercises.
D. Leaning forward over the bedside table: While this position may slightly assist in coughing, it does not provide as stable or effective support for diaphragmatic movement as sitting upright with feet flat, which promotes maximal lung expansion.
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Related Questions
Correct Answer is A
Explanation
A. An older adult with Alzheimer's who often wanders out of the room: The UAP can safely monitor and assist this client with ambulation, ensuring safety and preventing falls. Tasks like observation and redirecting the client are within the UAP’s scope of practice under supervision.
B. An adult postoperative client who is ready for discharge instructions: Discharge teaching involves providing education, assessing understanding, and reinforcing care plans, which are nursing responsibilities and cannot be delegated to a UAP.
C. An adolescent recently admitted with a suspected ruptured appendix: This client requires ongoing assessment, monitoring for signs of acute deterioration, and communication of findings to the RN, which are beyond the UAP’s scope.
D. An adult who is receiving blood and requires every 30 minute vital signs: Blood transfusion monitoring is a high-risk intervention requiring assessment skills, recognition of adverse reactions, and immediate nursing intervention, so it cannot be delegated to the UAP.
Correct Answer is A
Explanation
A. Observe the client closely for one hour: The immediate priority after a wrong medication is to monitor the client for adverse reactions or side effects. Close observation allows the PN to detect early signs of toxicity or complications and respond promptly.
B. Give an antidote to the medication: Administering an antidote is only appropriate if the medication has a known reversal agent and the client demonstrates symptoms. Giving one preemptively without signs can be unsafe.
C. Ask if the client can spit out the medication: Once a medication has been swallowed, it cannot reliably be removed, making this intervention ineffective and unsafe.
D. Report the error to the pharmacy: Reporting is necessary as part of follow-up and documentation, but the first action is to ensure client safety through observation and assessment before initiating reporting procedures.
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