The school nurse is teaching a group of adolescents about risk factors for lung cancer
and lung disease. Which of these would be included in the discussion?
1. Alcohol consumption
2. Cocaine use
3. Cigarette smoking
4. Heroin use
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3. Cigarette smoking
Rationale: Cigarette smoking is highly addictive and is the number-one risk
factor for lung cancer and chronic obstructive pulmonary disease.Alcohol
can cause some cancers and liver disease and can increase risky behaviors,
but it is not a major cause of lung cancer. Cocaine use, while highly
addictive, poses a risk for cardiovascular disorders such as ACS, MI, or
stroke. Heroin use does not increase one's risk of developing lung disease
or lung cancer.
,When caring for the client with chronic bronchitis, which of these interventions will
assist the client in mobilizing secretions?
1. Elevate the head of the bed 45 degrees
2. consume at least 2 liters of fluid daily
3. avoid triggers which cause coughing
4. assume the tripod position
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2. consume at least 2 liters of fluid daily
Rationale: Clients with chronic bronchitis tend to have thick secretions.
Hydration with at least 2 liters of fluid daily thins tenacious (sticky)
secretions, making them easier to expectorate. The goal is to consume fluid
to thin secretions and perform controlled coughing. If health issues require
fluid restriction, the client would attempt to consume the total amount
permitted.Head of bed elevation may promote oxygenation and lung
expansion, but does not promote secretion mobilization. Clients need to sit
with both feet on the floor when performing controlled coughing. The
tripod position is assumed during episodes of hypoxemia, but will not
facilitate mobilization of fluid.
When caring for a client who had a lobectomy the nurse notes small bubbles in the
water seal chamber of the disposable chest drainage device during coughing. Which
of these reflects the appropriate action by the nurse?
1. Document the finding in the medical record.
2. Check the tube for blood clots.
3. Briefly increase the amount of suction.
4. Add additional sterile water to the water seal chamber.
Give this one a try later!
, 1. Document the finding in the medical record.
Rationale: The nurse recognizes that gentle bubbling in the water seal
chamber is normal during the client's exhalation, forceful cough, or position
changes. This indicates air is leaving the pleural space which is the intended
purpose of the chest drain.Bubbling in the water seal chamber is absent if a
kink or a blockage is present because air would not be able to escape from
the chest cavity. Increasing the amount of suction without an order could
damage lung tissue. There is no indication that the level of fluid in the water
seal chamber is low.
A client with laryngeal cancer is admitted to the medical-surgical unit the morning
before a scheduled total laryngectomy. Which preoperative intervention can be
accomplished by an LPN/LVN working on the unit?
1. Administering preoperative antibiotics and anxiolytics
2. Assessing the client's nutritional status and need for nutrition supplements
3. Having the client sign the operative consent form
4. Teaching the client about the need for tracheal suctioning after surgery
Give this one a try later!
1. Administering preoperative antibiotics and anxiolytics
Rationale: Administering medication is a skill within the LPN/LVN scope of
practice. As a reminder, anxiolytics must be administered after the
operative consent has been signed, or the consent will be invalid.The
client's nutritional status and need for nutritional supplements should be
assessed by the RN or a registered dietitian as part of the multidisciplinary
care team. The surgeon is responsible for discussing the laryngectomy
procedure, answering any questions, and having the client sign the
operative consent form. Client teaching is the responsibility of the RN
because it requires complex critical thinking skills.
, The nurse is preparing the client for a diagnostic bronchoscopy. Which nursing
intervention is essential for the nurse to perform prior to the procedure?
1. Obtain informed consent.
2. Ensure the client has had nothing by mouth.
3. Review dietary and medication allergies.
4. Perform aggressive chest physiotherapy.
Give this one a try later!
2. Ensure the client has had nothing by mouth.
Rationale: When preparing a client for a diagnostic bronchoscopy, it is
essential for the nurse to make sure the client is NPO for 4 to 8 hours
before the procedure to reduce the risk for aspiration.It is important to
verify allergies, however ensuring NPO status is maintained is essential to
prevent aspiration, which can be life threatening. The nurse will verify that
consent for the procedure was obtained. Until the client has a gag reflex
and is fully alert, he or she should be maintained on NPO status to prevent
aspiration. Aggressive chest physiotherapy is not indicated in a client who
has had a bronchoscopy and may cause bleeding if biopsies have been
obtained.
A client with pneumonia is receiving 100% oxygen via a non-rebreather mask. Which of
these situations requires immediate intervention by the nurse?
1. The client's skin has pink color.
2. The oxygen reservoir deflates during inspiration.
3. The client has crackles at the lung bases.
4. The client is expectorating rust colored sputum.
Give this one a try later!
and lung disease. Which of these would be included in the discussion?
1. Alcohol consumption
2. Cocaine use
3. Cigarette smoking
4. Heroin use
Give this one a try later!
3. Cigarette smoking
Rationale: Cigarette smoking is highly addictive and is the number-one risk
factor for lung cancer and chronic obstructive pulmonary disease.Alcohol
can cause some cancers and liver disease and can increase risky behaviors,
but it is not a major cause of lung cancer. Cocaine use, while highly
addictive, poses a risk for cardiovascular disorders such as ACS, MI, or
stroke. Heroin use does not increase one's risk of developing lung disease
or lung cancer.
,When caring for the client with chronic bronchitis, which of these interventions will
assist the client in mobilizing secretions?
1. Elevate the head of the bed 45 degrees
2. consume at least 2 liters of fluid daily
3. avoid triggers which cause coughing
4. assume the tripod position
Give this one a try later!
2. consume at least 2 liters of fluid daily
Rationale: Clients with chronic bronchitis tend to have thick secretions.
Hydration with at least 2 liters of fluid daily thins tenacious (sticky)
secretions, making them easier to expectorate. The goal is to consume fluid
to thin secretions and perform controlled coughing. If health issues require
fluid restriction, the client would attempt to consume the total amount
permitted.Head of bed elevation may promote oxygenation and lung
expansion, but does not promote secretion mobilization. Clients need to sit
with both feet on the floor when performing controlled coughing. The
tripod position is assumed during episodes of hypoxemia, but will not
facilitate mobilization of fluid.
When caring for a client who had a lobectomy the nurse notes small bubbles in the
water seal chamber of the disposable chest drainage device during coughing. Which
of these reflects the appropriate action by the nurse?
1. Document the finding in the medical record.
2. Check the tube for blood clots.
3. Briefly increase the amount of suction.
4. Add additional sterile water to the water seal chamber.
Give this one a try later!
, 1. Document the finding in the medical record.
Rationale: The nurse recognizes that gentle bubbling in the water seal
chamber is normal during the client's exhalation, forceful cough, or position
changes. This indicates air is leaving the pleural space which is the intended
purpose of the chest drain.Bubbling in the water seal chamber is absent if a
kink or a blockage is present because air would not be able to escape from
the chest cavity. Increasing the amount of suction without an order could
damage lung tissue. There is no indication that the level of fluid in the water
seal chamber is low.
A client with laryngeal cancer is admitted to the medical-surgical unit the morning
before a scheduled total laryngectomy. Which preoperative intervention can be
accomplished by an LPN/LVN working on the unit?
1. Administering preoperative antibiotics and anxiolytics
2. Assessing the client's nutritional status and need for nutrition supplements
3. Having the client sign the operative consent form
4. Teaching the client about the need for tracheal suctioning after surgery
Give this one a try later!
1. Administering preoperative antibiotics and anxiolytics
Rationale: Administering medication is a skill within the LPN/LVN scope of
practice. As a reminder, anxiolytics must be administered after the
operative consent has been signed, or the consent will be invalid.The
client's nutritional status and need for nutritional supplements should be
assessed by the RN or a registered dietitian as part of the multidisciplinary
care team. The surgeon is responsible for discussing the laryngectomy
procedure, answering any questions, and having the client sign the
operative consent form. Client teaching is the responsibility of the RN
because it requires complex critical thinking skills.
, The nurse is preparing the client for a diagnostic bronchoscopy. Which nursing
intervention is essential for the nurse to perform prior to the procedure?
1. Obtain informed consent.
2. Ensure the client has had nothing by mouth.
3. Review dietary and medication allergies.
4. Perform aggressive chest physiotherapy.
Give this one a try later!
2. Ensure the client has had nothing by mouth.
Rationale: When preparing a client for a diagnostic bronchoscopy, it is
essential for the nurse to make sure the client is NPO for 4 to 8 hours
before the procedure to reduce the risk for aspiration.It is important to
verify allergies, however ensuring NPO status is maintained is essential to
prevent aspiration, which can be life threatening. The nurse will verify that
consent for the procedure was obtained. Until the client has a gag reflex
and is fully alert, he or she should be maintained on NPO status to prevent
aspiration. Aggressive chest physiotherapy is not indicated in a client who
has had a bronchoscopy and may cause bleeding if biopsies have been
obtained.
A client with pneumonia is receiving 100% oxygen via a non-rebreather mask. Which of
these situations requires immediate intervention by the nurse?
1. The client's skin has pink color.
2. The oxygen reservoir deflates during inspiration.
3. The client has crackles at the lung bases.
4. The client is expectorating rust colored sputum.
Give this one a try later!
