NCSBN Exam with Questions and Verified Answers

NCSBN Exam with Questions and Verified Answers The nurse is performing a physical assessment on a client who just had an endotracheal tube (ET) inserted with a connection to a ventilator. Which finding should prompt the nurse to take immediate action to resolve the issue? A. Client is unable to speak B. Mist is visible in the T-Piece of the ventilator circuit C. Pulse oximetry of 86% saturation D. Breath sounds are heard bilaterally ANSWER C Pulse oximetry should not be lower than 90% saturation. Breath sounds are heard bilaterally so the placement of an ET is most likely in proper position. The ventilator settings will need to be rechecked. A client with an ET tube in place will not be able to talk when the ET tube balloon is inflated. In order to enhance a client's response to medication for chest pain from acute angina, the nurse should emphasize which approach? A. Eat smaller meals B. Limiting alcohol use C. Avoiding passive smoke D. Learning relaxation techniques ANSWER D The only factor that can enhance the client's response to pain medication for angina is reduction of anxiety through relaxation methods. Anxiety may increase intensity to a point where pain medication outcomes are totally ineffective.