Chest Tube NCLEX (76-80)

Welcome to Chest Tube NCLEX. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. 

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76. A client is prescribed rifampin (Rifadin), 600 mg P.O. daily. Which statement about rifampin is true?

a) It's usually given alone.
b) Its exact mechanism of action is unknown.
c) It's tuberculocidal, destroying the offending bacteria.
d) It acts primarily against resting bacteria

77. The amount of air inspired and expired with each breath is called:

a) tidal volume.
b) residual volume.
c)vital capacity.
d) dead-space volume.

78. A recent immigrant from Vietnam is diagnosed with pulmonary tuberculosis (TB). Which intervention is most important for the nurse to implement with this client?

a) Client teaching about the cause of TB
b) Reviewing the risk factors for TB
c) Developing a list of people with whom the client has had contact
d) Client teaching about the importance of TB testing

79. After undergoing a left thoracotomy, a client has a chest tube in place. When caring for this client, the nurse must:

a) report fluctuations in the water-seal chamber.
b) clamp the chest tube once every shift.
c) encourage coughing and deep breathing.
d) milk the test tube every 2 hours.

80. The home health nurse sees a client with end-stage chronic obstructive pulmonary disease. An outcome identified for this client is preventing infection. Which finding indicates that this outcome has been met?

a) Decreased oxygen requirements
b) Increased sputum production
c) Decreased activity tolerance
d) Normothermia




Chest Tube NCLEX
Answers and Rationale

76) C
- Rifampin may be tuberculocidal or tuberculostatic against the Mycobacterium tuberculosis bacteria. It's usually given with other antitubercular drugs to prevent or delay resistance. The drug impairs ribonucleic acid synthesis of bacteria. It acts against, active not resting, bacteria.

77) A
- Tidal volume is the amount of air inspired and expired with each breath. Residual volume is the amount of air remaining in the lungs after forcibly exhaling. Vital capacity is the maximum amount of air that can be moved out of the lungs after maximal inspiration and expiration. Dead-space volume is the amount of air remaining in the upper airways that never reaches the alveoli. In pathologic conditions, dead space may also exist in the lower airways.

78) C
- To lessen the spread of TB, everyone who had contact with the client must undergo a chest X-ray and TB test skin. Testing will help determine if the client infected anyone else. The remaining options are important areas to address when educating high-risk populations about TB is prior to its development.

79) C
- When caring for a client who's recovering from a thoracotomy, the nurse should encourage coughing and deep breathing to prevent pneumonia. Fluctuations in the water-seal chamber are normal. Clamping the chest tube could cause a tension pneumothorax. Chest tube milking is controversial and should be done only to remove blood clots that obstruct the flow of drainage.

80) A
- A client who is free from infection will most likely have decreased oxygen requirements. A client with infection will display increased sputum production, fever, shortness of breath, decreased activity tolerance, and increased oxygen requirements.


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Chest Tube NCLEX (1-6)


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Chest Tube NCLEX (81-85)

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Respiratory NCLEX Practice Questions (71-75)

Welcome to NCLEX Review Respiratory Questions. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. 

Good Luck.

71. Before weaning a client from a ventilator, which assessment parameter is most important for the nurse to review?

a) Fluid intake for the past 24 hours
b) Baseline arterial blood gas (ABG) levels
c) Prior outcomes of weaning
d) Electrocardiogram (ECG) results

72. The nurse is assessing the puncture site of the client who has received a purified protein derivative test. Which finding indicates a need for further evaluation?

a) 15-mm induration
b) Reddened area
c) 10-mm induration
d) Blister

73. A client who under went surgery 12 hours ago has difficulty breathing. He has petechiae over his chest and complains of acute chest pain. What action should the nurse take first

a) Initiate oxygen therapy.
b) Administer a heparin bolus and begin an infusion at 500 units/hour.
c) Administer analgesics as ordered.
d) Perform nasopharyngeal suctioning.

74. A client with colorectal carcinoma is devastated after learning that the cancer has spread to the liver and lungs and the client has only a 5% chance surviving for 5 years. Which comment by the nurse would best help the client cope with this news?

a) "I've seen clients in your situation who have lived almost 20 years."
b) "It must be hard to hear that prognosis. Would it help you to talk to me or the chaplain?"
c) "This might be a good time to think about an advance directive in case you run into problems while you're here."
d) "Those are just numbers. You have to live each day fully and not worry about dying."

75. Inspiratory and expiratory stridor may be heard in a client who:

a) is experiencing an exacerbation of goiter
b) is experiencing an acute asthmatic attack.
c) has aspirated a piece of meat
d) has severe laryngotracheitis




Respiratory NCLEX Practice Questions
Answers and Rationale

71) B
- Before weaning a client from mechanical ventilation, it's most important to have a baseline ABG levels. During the weaning process, ABG levels will be checked to assess how the client is tolerating the procedure. Other assessment parameters are less critical. Measuring fluid volume intake and output is always important when a client is being mechanically ventilated. Prior attempts at weaning and ECG results are documented on the client's record, and the nurse can refer to them before the weaning process begins.

72) A
- A 10-mm induration strongly suggests a positive response in this tuberculosis screening test; a 15-mm induration clearly requires further evaluation. The other options aren't positive reactions to the test and require no further evaluation.

73) A
- The client's signs and symptoms suggest pulmonary embolism. therefore, maintaining respiratory function takes priority. The nurse should first initiate oxygen therapy and then notify the physician immediately. The physician will most likely prescribe an anticoagulant, such as heparin, or an antithrombolytic to dissolve the thrombus. Analgesics can be administered to decrease pain and anxiety but administering oxygen takes priority. Suctioning typically isn't necessary with pulmonary embolism.

74) B
- This response is most therapeutic because it encourages the client to express feelings and concerns. Options A and D offer false hope and reflect the nurse's empirical observations, not statistics. Option C is inappropriate because an informed person who isn't a member of the health care team should discuss (at the client's request) which level of care the client wishes to receive in case of an emergency.

75) C
- Inspiratory and expiratory stridor is a low-pitched crowing sound heard in client who have a foreign body obstructing the trachea or mainstem bronchi. Acute asthmatic attacks are characterized by wheezing. Goiter attacks and severe laryngotracheitis are associated with inspiratory  stridor only.


After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Respiratory NCLEX Practice Questions (1-6)


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Respiratory NCLEX Practice Questions (76-80)

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Respiratory NCLEX Practice Questions (66-70)

Welcome to NCLEX Review Respiratory Questions. Enjoy answering and I hope that NCLEX Review and Secrets can somehow help you in your future examination. 

Good Luck.

66. A client with end-stage chronic obstructive pulmonary disease requires bi-level positive airway pressure (BiPAP). While caring for the client, the nurse determines that bilateral wrist restraints are required to prevent compromised care. Which client care outcome is associated with restraint use in the client who requires BiPAP?

a) The client will remain infection-free

b) The client will maintain adequate oxygenation.

c) The client will maintain adequate urine output

d) The client will remain pain-free

67. A 52-year-old client who just emigrated from Mexico is admitted with tuberculosis. The client explains to the nurse through an interpreter that he's concerned about paying for his medications after discharge. The nurse should collaborate with which health care team member about the client's financial concerns?

a) Public health worker

b) Home health nurse

c) Physician

d) Social worker

68. During the insertion of a rigid scope for bronchoscopy, a client experiences a vasovagal response. The nurse should expect

a) The client's pupils to become dilated

b) The client to experience bronchodilation

c) A decrease in the client's gastric secretions.

d) A drop in the client's heart rate.

69. A client with chronic sinusitis comes to the outpatient department complaining of headache, malaise, and a nonproductive cough. When examining the client's paranasal sinuses, the nurse detects tenderness. To evaluate this finding further, the nurse should transilluminate the:

a) frontal sinuses only

b) sphenoidal sinuses only

c) frontal and maxillary sinuses

d) sphenoidal and ethmoidal sinuses.

70. A client with severe acute respiratory syndrome (SARS) privately informs the nurse that he doesn't want to be placed on a ventilator if his condition worsens. The client's wife and children have repeatedly expressed their desire that everything be done for the client. The most appropriate action by the nurse would be to.

a) inform the family of the client's wishes.

b) assure the family that everything possible will be done.

c) support the client's decision

d) assure the client that everything possible will be done.

Respiratory NCLEX Practice Questions

Answers and Rationale

66) B

- BiPAP is a type of continuous positive airway pressure in which both inspiratory and expiratory pressures are set above atmospheric pressure. This type of ventilatory support assists clients with chronic obstructive pulmonary disease who retain PaCO2. Restrains are necessary in this client to maintain BiPAP therapy if the client attempts to dislodge the mask despite instruction no to do so. Maintaining  oxygenation is the expected outcome in this client. Options A, C, and D aren't direct outcomes of the client requiring BiPAP who needs restraints to maintain client safety.

67) D

- The nurse should collaborate with the social worker about the client's financial concerns. This collaboration can be done independently without a physician's order. The physician must only notify the public health department of the client's diagnoses. The physician and home health nurse are also involved in the client's care but aren't typically involved with the client's financial concerns until after the client is discharged

 68) D

- During a bronchoscopy, a vasovagal response may be caused by stimulating the pharynx, and it, in turn, may cause stimulation vagus nerve. The client may, therefore, experience a sudden drop in heart rate leading to syncope. Stimulation of the vagus nerve doesn't lead to pupillary dilation or bronchodilation, Stimulation of the vagus nerve increases gastric secretions.

69) C

- After detecting tenderness of the paranasal sinuses, the nurse should transilluminate both frontal and maxillary sinuses; lack of illumination may indicate sinus congestion and pus accumulation. The sphenoidal and ethmoidal sinuses can't be transilluminated because of their location.

70) C

- The nurse is obligated to act as client advocate. The nurse shouldn't discuss the issue with the client's family unless the client gives permission. Answers B and D oppose the client's wishes and don't demonstrate client advocacy

After you reviewed your answers through its rationale, you can also go back to the first page to start from the beginning:

Respiratory NCLEX Practice Questions (1-6)


Or proceed to the next set of questions:
 
Respiratory NCLEX Practice Questions (71-75)

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