George, who has undergone thoracic surgery has a chest tube connected to a water-seal drainage system attached to suction. Presence of excessive bubbling is identified in the water-seal chamber, the nurse should: A. “Strip” the chest tube catheter B. Check the system for air leaks C. Recognize the system is functioning correctly… Read More »
A nurse caring for several patients in the cardiac unit is told that one is scheduled for implantation of an automatic internal cardioverter-defibrillator. Which of the following patients is most likely to have this procedure? A. A patient admitted for myocardial infarction without cardiac muscle damage. B. A postoperative coronary bypass patient, recovering on schedule.… Read More »
Nurse Michelle should know that the drainage is normal four (4) days after a sigmoid colostomy when the stool is: A. Green liquid B. Solid formed C. Loose, bloody D. Semiformed Correct Answer: C. Loose, bloody Normal bowel function and soft-formed stool usually do not occur until… Read More »
The client is admitted with right-sided congestive heart failure. In assessing the client for edema, the nurse should check the: A. Feet B. Neck C. Hands D. Sacrum Correct Answer: B. Neck The jugular veins in the neck should be assessed for distension. Increased blood volume, which… Read More »
A patient is scheduled for a magnetic resonance imaging (MRI) scan for suspected lung cancer. Which of the following is a contraindication to the study for this patient? A. The patient is allergic to shellfish. B. The patient has a pacemaker. C. The patient suffers from claustrophobia. D. The patient takes… Read More »
Which laboratory test value is elevated in clients who smoke and can’t be used as a general indicator of cancer? A. Acid phosphatase level B. Serum calcitonin level C. Alkaline phosphatase level D. Carcinoembryonic antigen level Correct Answer: D. Carcinoembryonic antigen level In clients who smoke, the… Read More »
The nurse is checking the client’s central venous pressure. The nurse should place the zero of the manometer at the: A. Phlebostatic axis B. PMI C. Erb’s point D. Tail of Spence Correct Answer: A. Phlebostatic axis The phlebostatic axis is located at the fifth intercostal space… Read More »
A patient comes to the emergency department with abdominal pain. Work-up reveals the presence of a rapidly enlarging abdominal aortic aneurysm. Which of the following actions should the nurse expect? A. The patient will be admitted to the medicine unit for observation and medication. B. The patient will be admitted to the day… Read More »
Nurse Lucy is planning to give preoperative teaching to a client who will be undergoing rhinoplasty. Which of the following should be included? A. Results of the surgery will be immediately noticeable postoperatively B. Normal saline nose drops will need to be administered preoperatively C. After surgery, nasal packing will be in… Read More »
The nurse is changing the ties of the client with a tracheostomy. The safest method of changing the tracheostomy ties is to: A. Apply the new tie before removing the old one. B. Have a helper present. C. Hold the tracheostomy with the nondominant hand while removing the old tie. D.… Read More »