What information would be important for the nurse to reinforce when teaching a pre-operative client about the correct use of the patient-controlled analgesia (PCA) device to achieve the best outcome?

“Try to go as long as possible before you press the button.”

“Instruct your family or visitors to press the button for you when you are sleeping.”

“Push the button every 15 minutes whether you feel pain at that time or not.”

“Push the button when you begin to feel pain, instead of waiting until the pain becomes worse.”

Answer and Explanation

The Correct Answer is D

Choice A reason:

Telling the patient to “try to go as long as possible before you press the button” is not advisable. PCA devices are designed to allow patients to manage their pain effectively by administering medication as soon as they begin to feel discomfort. Delaying the use of the PCA can lead to uncontrolled pain, which can be more difficult to manage later.

Choice B reason:

“Instruct your family or visitors to press the button for you when you are sleeping” is incorrect and potentially dangerous. Only the patient should press the PCA button to ensure that they are receiving the medication when they actually need it. Allowing others to press the button can lead to overmedication and serious side effects.

Choice C reason:

“Push the button every 15 minutes whether you feel pain at that time or not” is also incorrect. PCA devices are intended to be used on an as-needed basis. Pressing the button at regular intervals without experiencing pain can result in unnecessary medication administration and potential overdose.

Choice D reason:

“Push the button when you begin to feel pain, instead of waiting until the pain becomes worse” is the correct instruction. This approach helps to manage pain more effectively by preventing it from becoming severe. Early intervention with pain management can lead to better overall outcomes and patient comfort.

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Correct Answer is C

Explanation

Choice A reason:

Improving the ciliary movement in the lungs is not the primary purpose of chest physiotherapy. While ciliary movement is important for clearing mucus, CPT specifically aims to mobilize and remove secretions through techniques such as percussion, vibration, and postural drainage.

Choice B reason:

Increasing the ability to take deep breaths is not the main goal of chest physiotherapy. Although CPT can indirectly help improve lung function by clearing secretions, its primary purpose is to facilitate the removal of mucus from the lungs.

Choice C reason:

Loosening secretions in congested areas of the lungs is the most accurate reason for ordering chest physiotherapy. CPT helps to mobilize and clear mucus, which can improve ventilation and gas exchange, reduce the risk of infection, and aid in the recovery process.

Choice D reason:

Increasing the oxygen supply to your tissues is not the direct aim of chest physiotherapy. While clearing secretions can improve overall lung function and oxygenation, the primary goal of CPT is to remove mucus from the airways.

A. Initiate droplet precautions. B. Consider standard precautions to be sufficient. C. Transfer the client to a positive pressure room. D. Initiate airborne precautions. E. Transferring the client to a positive pressure room is inappropriate. Positive pressure rooms are designed to keep contaminants out and are used for protecting immunocompromised patients from infections. For a client with suspected TB, a negative pressure room is required to prevent the spread of infectious particles to other areas.

Correct Answer is D

Explanation

Choice A reason:

Initiating droplet precautions is not sufficient for a client presenting with symptoms such as coughing up blood, productive cough, and night sweats. These symptoms are indicative of possible tuberculosis (TB), which is an airborne disease. Droplet precautions are used for infections spread through large respiratory droplets, such as influenza or pertussis, but not for TB.

Choice B reason:

Considering standard precautions to be sufficient is incorrect. Standard precautions are the basic level of infection control that should be used in the care of all patients to prevent the spread of infections. However, for a client with symptoms suggestive of TB, additional airborne precautions are necessary to prevent the spread of the disease.

Choice C reason:

Transferring the client to a positive pressure room is inappropriate. Positive pressure rooms are designed to keep contaminants out and are used for protecting immunocompromised patients from infections. For a client with suspected TB, a negative pressure room is required to prevent the spread of infectious particles to other areas.

Choice D reason:

Initiating airborne precautions is the correct intervention. Airborne precautions are necessary for diseases that are transmitted through smaller respiratory droplets that can remain suspended in the air and be inhaled by others. Tuberculosis is one such disease, and initiating airborne precautions helps to prevent the spread of the infection to healthcare workers and other patients.

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What information would be important for the nurse to reinforce when teaching a pre-operative client about the correct use of the patient-controlled analgesia (PCA) device to achieve the best outcome?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client diagnosed with pneumonia asks the nurse, “Why did my physician order chest physiotherapy (CPT) for me?” Which response by the nurse is most accurate? Chest physiotherapy will:

Correct Answer is C

Explanation

A nurse is assessing a newly admitted client whose chief complaint is “coughing up blood” and whose recent history includes a productive cough and night sweats. What is the nurse’s priority intervention?

Correct Answer is D

Explanation

A client is diagnosed with asthma. The therapeutic regimen using metered dose inhalers includes albuterol 2 puffs and beclomethasone 2 puffs. The nursing plan of care must include teaching regarding:

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The nurse is assessing the client and notes fine crackles throughout the lungs bilaterally. This assessment finding is often associated with:

The nurse is discharging a client newly diagnosed with tuberculosis. Which medications should be included in the discharge planning? (SELECT ALL THAT APPLY)

The nurse is reviewing the history of a client admitted with newly diagnosed chronic bronchitis. Which question by the nurse confirms this diagnosis?

A client who receives an antihypertensive medication daily is NPO except medications for surgery. The most recent blood pressure recording is 174/88. What action should the nurse take first?

The physician prescribed albuterol, beclomethasone, and zafirlukast for a client being discharged with asthma. The client tells the nurse he can’t remember what to take before exercising. The best response by the nurse would be: