Nursing practice questions with comprehensive rationales
NurseDive Free Nursing Practice Question
A nurse is evaluating a 4-year-old child who has cystic fibrosis and has been receiving chest physiotherapy treatments.
The nurse should identify which of the following findings as an indication that the therapy has been effective?
A. Increased urine output.
Choice A is wrong because increased urine output is not an indication of the effectiveness of chest physiotherapy.
B. Increased expectoration.
Chest physiotherapy treatments aim to improve ventilation and mucociliary clearance by removing tenacious and obstructing secretions in patients with cystic fibrosis. Increased expectoration indicates that the therapy has been effective in clearing secretions.
C. Reduced pain.
Choice C is wrong because reduced pain is not a specific indication of the effectiveness of chest physiotherapy.
D. Increased heart rate.
Choice D is wrong because increased heart rate is not an indication of the effectiveness of chest physiotherapy.
E. Increased heart rate.
This question is an excerpt from Nurse Dive's nursing test bank - ATI RN Nursing Care of Children 2019 Proctored Exam. Take the full exam now
Full Explanation
Chest physiotherapy treatments aim to improve ventilation and mucociliary clearance by removing tenacious and obstructing secretions in patients with cystic fibrosis.
Increased expectoration indicates that the therapy has been effective in clearing secretions.
Choice A is wrong because increased urine output is not an indication of the effectiveness of chest physiotherapy.
Choice C is wrong because reduced pain is not a specific indication of the effectiveness of chest physiotherapy.
Choice D is wrong because increased heart rate is not an indication of the effectiveness of chest physiotherapy.
Similar Questions
A nurse is preparing to collect a urine specimen from a female infant using a urine collection bag.
Which of the following actions should the nurse take?
A. Position the opening of the bag over the urethra and the anus.
The nurse should position the opening of the bag over the urethra and the anus.
B. Place a snug-fitting diaper over the drainage bag.
Choice B is wrong because placing a snug-fitting diaper over the drainage bag is not necessary.
C. Apply lidocaine gel to the perineum before attaching the bag.
Choice C is wrong because there is no need to apply lidocaine gel to the perineum before attaching the bag.
D. Stretch the perineum taut when applying the bag.
Choice D is wrong because there is no need to stretch the perineum taut when applying the bag.
Full Explanation
The nurse should position the opening of the bag over the urethra and the anus.
Choice B is wrong because placing a snug-fitting diaper over the drainage bag is not necessary.
Choice C is wrong because there is no need to apply lidocaine gel to the perineum before attaching the bag.
Choice D is wrong because there is no need to stretch the perineum taut when applying the bag.
A nurse is teaching home care to the parents of a preschool-age child who has heart failure.
Which of the following information should the nurse include in the teaching?
A. Increase the child's oxygen flow rate until the child no longer has cyanosis.
Choice A is wrong because increasing the child’s oxygen flow rate should be done under the guidance of a healthcare provider.
B. Weigh the child once each month.
Choice B is wrong because it is important to monitor the child’s weight more frequently than once a month.
C. Withhold digoxin if the child's pulse is greater than 100/min.
Choice C is wrong because digoxin is a medication that can help the heart beat stronger with a more regular rhythm and should not be withheld based on pulse rate alone.
D. Provide for periods of rest.
Provide for periods of rest. Children with heart failure may have trouble breathing, especially with activity, and may feel tired. It is important for them to have periods of rest to help manage their symptoms.
Full Explanation
Provide for periods of rest.
Children with heart failure may have trouble breathing, especially with activity, and may feel tired.
It is important for them to have periods of rest to help manage their symptoms.
Choice A is wrong because increasing the child’s oxygen flow rate should be done under the guidance of a healthcare provider.
Choice B is wrong because it is important to monitor the child’s weight more frequently than once a month.
Choice C is wrong because digoxin is a medication that can help the heart beat stronger with a more regular rhythm and should not be withheld based on pulse rate alone.
A nurse is reviewing the laboratory results of a preschooler who has gastroenteritis and notes the client's potassium level is.2 mEq/L.
Which of the following assessment findings should the nurse expect?
A. Oliguria.
Choice A is wrong because oliguria, or decreased urine output, is not a common symptom of low potassium levels.
B. Hypertension.
Choice B is wrong because hypertension, or high blood pressure, is not a common symptom of low potassium levels.
C. Hyporeflexia.
A potassium level of.2 mEq/L is considered low. Low potassium levels can cause muscle weakness and spasms. Hyporeflexia refers to below normal or absent reflexes and can be a sign of muscle weakness.
D. Hyperactive bowel sounds.
Choice D is wrong because hyperactive bowel sounds are not a common symptom of low potassium levels.
Full Explanation
A potassium level of.2 mEq/L is considered low.
Low potassium levels can cause muscle weakness and spasms.
Hyporeflexia refers to below normal or absent reflexes and can be a sign of muscle weakness.
Choice A is wrong because oliguria, or decreased urine output, is not a common symptom of low potassium levels.
Choice B is wrong because hypertension, or high blood pressure, is not a common symptom of low potassium levels.
Choice D is wrong because hyperactive bowel sounds are not a common symptom of low potassium levels.