Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is caring for a client who has acute respiratory distress syndrome (ARDS) and requires mechanical ventilation. The client receives a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes?
A. Decrease respiratory secretions.
Decrease respiratory secretions. This answer is incorrect because pancuronium does not have any effect on the production or clearance of respiratory secretions. This medication is not used to treat the pulmonary edema and inflammation that occur in ARDS.
B. Induce sedation
Induce sedation. This answer is incorrect because pancuronium does not have any sedative or analgesic properties. This medication does not affect the level of consciousness or pain perception of the client. A client who receives pancuronium should also receive adequate sedation and analgesia to prevent anxiety and discomfort.
C. Suppress respiratory effort
Suppress respiratory effort. This answer is correct because pancuronium is a neuromuscular blocker that inhibits the transmission of nerve impulses to the muscles, causing paralysis and relaxation. This medication is used to suppress the respiratory effort of the client and allow the mechanical ventilator to control the breathing.
D. Decrease chest wall compliance
Decrease chest wall compliance. This answer is incorrect because pancuronium does not have any effect on the elasticity or stiffness of the chest wall. This medication is not used to treat the reduced lung compliance and increased airway resistance that occur in ARDS.
This question is an excerpt from Nurse Dive's nursing test bank - Ati Pharmacology Proctored Exam. Take the full exam now
Full Explanation
Choice A reason: Decrease respiratory secretions. This answer is incorrect because pancuronium does not have any effect on the production or clearance of respiratory secretions. This medication is not used to treat the pulmonary edema and inflammation that occur in ARDS.
Choice B reason: Induce sedation. This answer is incorrect because pancuronium does not have any sedative or analgesic properties. This medication does not affect the level of consciousness or pain perception of the client. A client who receives pancuronium should also receive adequate sedation and analgesia to prevent anxiety and discomfort.
Choice C reason: Suppress respiratory effort. This answer is correct because pancuronium is a neuromuscular blocker that inhibits the transmission of nerve impulses to the muscles, causing paralysis and relaxation. This medication is used to suppress the respiratory effort of the client and allow the mechanical ventilator to control the breathing.
Choice D reason: Decrease chest wall compliance. This answer is incorrect because pancuronium does not have any effect on the elasticity or stiffness of the chest wall. This medication is not used to treat the reduced lung compliance and increased airway resistance that occur in ARDS.
Similar Questions
A nurse is instructing a client’s family members about feeding safety for a client who has dysphagia following a stroke. Which of the following instructions should the nurse include?
A. Encourage brief exercise before meals to promote appetite.
Encourage brief exercise before meals to promote appetite. This answer is incorrect because exercise before meals can increase fatigue and decrease appetite in some clients with dysphagia. Exercise can also affect the blood flow to the brain and the muscles involved in swallowing .
B. Encourage the client to take small bites.
Encourage the client to take small bites. This answer is correct because taking small bites can help the client swallow more easily and reduce the risk of choking or aspiration.
C. Place the client with the head reclined back to facilitate swallowing.
Place the client with the head reclined back to facilitate swallowing. This answer is incorrect because placing the client with the head reclined back can impair the swallowing mechanism and increase the risk of aspiration. The client should be placed with the head tilted slightly forward to help the food move down the throat.
D. Place food in the affected side of the mouth.
Place food in the affected side of the mouth. This answer is incorrect because placing food in the affected side of the mouth can cause the food to remain in the mouth and not be swallowed properly. The client should be encouraged to use both sides of the mouth to chew and swallow food.
Full Explanation
Choice A reason: Encourage brief exercise before meals to promote appetite. This answer is incorrect because exercise before meals can increase fatigue and decrease appetite in some clients with dysphagia. Exercise can also affect the blood flow to the brain and the muscles involved in swallowing .
Choice B reason: Encourage the client to take small bites. This answer is correct because taking small bites can help the client swallow more easily and reduce the risk of choking or aspiration.
Choice C reason: Place the client with the head reclined back to facilitate swallowing. This answer is incorrect because placing the client with the head reclined back can impair the swallowing mechanism and increase the risk of aspiration. The client should be placed with the head tilted slightly forward to help the food move down the throat.
Choice D reason: Place food in the affected side of the mouth. This answer is incorrect because placing food in the affected side of the mouth can cause the food to remain in the mouth and not be swallowed properly. The client should be encouraged to use both sides of the mouth to chew and swallow food.
A nurse is providing teaching to a client who has asthma and a new prescription for inhaled beclomethasone. Which of the following instructions should the nurse provide?
A. Rinse the mouth after administration.
Rinse the mouth after administration. This answer is correct because rinsing the mouth after using inhaled beclomethasone can help prevent oral candidiasis, a fungal infection that can cause soreness, white patches, and bleeding in the mouth.
B. Check the pulse after medication administration.
Check the pulse after medication administration. This answer is incorrect because checking the pulse after using inhaled beclomethasone is not necessary, as this medication does not affect the heart rate or blood pressure. Inhaled beclomethasone is a corticosteroid that reduces inflammation and swelling in the airways.
C. Limit caffeine intake.
Limit caffeine intake. This answer is incorrect because limiting caffeine intake is not related to the use of inhaled beclomethasone, but rather to the management of asthma symptoms. Caffeine can act as a bronchodilator and improve lung function, but it can also cause nervousness, insomnia, and palpitations in some people.
D. Take the medication with meals.
Take the medication with meals. This answer is incorrect because taking the medication with meals is not relevant to the use of inhaled beclomethasone, as this medication is not taken orally but by inhalation. Inhaled beclomethasone is delivered directly to the lungs, where it exerts its anti-inflammatory effect.
Full Explanation
Choice A reason: Rinse the mouth after administration. This answer is correct because rinsing the mouth after using inhaled beclomethasone can help prevent oral candidiasis, a fungal infection that can cause soreness, white patches, and bleeding in the mouth.
Choice B reason: Check the pulse after medication administration. This answer is incorrect because checking the pulse after using inhaled beclomethasone is not necessary, as this medication does not affect the heart rate or blood pressure. Inhaled beclomethasone is a corticosteroid that reduces inflammation and swelling in the airways.
Choice C reason: Limit caffeine intake. This answer is incorrect because limiting caffeine intake is not related to the use of inhaled beclomethasone, but rather to the management of asthma symptoms. Caffeine can act as a bronchodilator and improve lung function, but it can also cause nervousness, insomnia, and palpitations in some people.
Choice D reason: Take the medication with meals. This answer is incorrect because taking the medication with meals is not relevant to the use of inhaled beclomethasone, as this medication is not taken orally but by inhalation. Inhaled beclomethasone is delivered directly to the lungs, where it exerts its anti-inflammatory effect.
A nurse is caring for a client who has a disposable three chamber chest tube in place. Which of the following findings should indicate to the nurse that the client is experiencing a complication?
A. Occasional bubbling in the water seal chamber
Occasional bubbling in the water seal chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Occasional bubbling in the water seal chamber occurs when the client exhales, coughs, or sneezes, and it shows that air is being removed from the pleural space.
B. Continuous bubbling in the water seal chamber
Continuous bubbling in the water seal chamber. This finding indicates that the client is experiencing a complication because it suggests that there is an air leak in the chest tube system. An air leak can prevent the lung from expanding and cause respiratory distress.
C. Fluctuations in the fluid level in the water seal chamber
Fluctuations in the fluid level in the water seal chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Fluctuations in the fluid level in the water seal chamber occur when the client breathes, and they show that the pressure in the pleural space is changing.
D. Constant bubbling in the suction control chamber
Constant bubbling in the suction control chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Constant bubbling in the suction control chamber occurs when the suction source is connected, and it shows that the suction is working.
Full Explanation
Choice A reason: Occasional bubbling in the water seal chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Occasional bubbling in the water seal chamber occurs when the client exhales, coughs, or sneezes, and it shows that air is being removed from the pleural space.
Choice B reason: Continuous bubbling in the water seal chamber. This finding indicates that the client is experiencing a complication because it suggests that there is an air leak in the chest tube system. An air leak can prevent the lung from expanding and cause respiratory distress.
Choice C reason: Fluctuations in the fluid level in the water seal chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Fluctuations in the fluid level in the water seal chamber occur when the client breathes, and they show that the pressure in the pleural space is changing.
Choice D reason: Constant bubbling in the suction control chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Constant bubbling in the suction control chamber occurs when the suction source is connected, and it shows that the suction is working.