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Free NCLEX-RN Exam Braindumps (page: 16)

Page 15 of 431
PDF with 862 Questions

In a client with chest trauma, the nurse needs to evaluate mediastinal position. This can best be done by:

  1. Auscultating bilateral breath sounds
  2. Palpating for presence of crepitus
  3. Palpating for trachial deviation
  4. Auscultating heart sounds

Answer(s): C

Explanation:

(A) No change in the breath sounds occurs as a direct result of the mediastinal shift. (B) Crepitus can occur owing to the primary disorder, not to the mediastinal shift. (C) Mediastinal shift occurs primarily with tension pneumothorax, but it can occur with very large hemothorax or pneumothorax. Mediastinal shift causes trachial deviation and deviation of the heart's point of maximum impulse. (D) No change in the heart sounds occurs as a result of the mediastinal shift.



In a client with chest trauma, the nurse needs to evaluate mediastinal position. This can best be done by:

  1. Auscultating bilateral breath sounds
  2. Palpating for presence of crepitus
  3. Palpating for trachial deviation
  4. Auscultating heart sounds

Answer(s): C

Explanation:

(A) No change in the breath sounds occurs as a direct result of the mediastinal shift. (B) Crepitus can occur owing to the primary disorder, not to the mediastinal shift. (C) Mediastinal shift occurs primarily with tension pneumothorax, but it can occur with very large hemothorax or pneumothorax. Mediastinal shift causes trachial deviation and deviation of the heart's point of maximum impulse. (D) No change in the heart sounds occurs as a result of the mediastinal shift.



The physician has ordered that a daily exercise program be instituted by a client with type I diabetes following his discharge from the hospital. Discharge instructions about exercise should include which of the following?

  1. Exercise should be performed 30 minutes before meals.
  2. A snack may be needed before and/or during exercise.
  3. Hyperglycemia may occur 2­4 hours after exercise.
  4. The blood glucose level should be 100 mg or below before exercise is begun.

Answer(s): B

Explanation:

(A) Exercise should not be performed before meals because the blood sugar is usually lower just prior to eating; therefore, there is an increased risk for hypoglycemia. (B) Exercise lowers blood sugar levels; therefore, a snack may be needed to maintain the appropriate glucose level. (C) Exercise lowers blood sugar levels. (D) Exercise lowers blood sugar levels. If the blood glucose level is 100 mg or below at the start of exercise, the potential for hypoglycemia is greater.



The physician has ordered that a daily exercise program be instituted by a client with type I diabetes following his discharge from the hospital. Discharge instructions about exercise should include which of the following?

  1. Exercise should be performed 30 minutes before meals.
  2. A snack may be needed before and/or during exercise.
  3. Hyperglycemia may occur 2­4 hours after exercise.
  4. The blood glucose level should be 100 mg or below before exercise is begun.

Answer(s): B

Explanation:

(A) Exercise should not be performed before meals because the blood sugar is usually lower just prior to eating; therefore, there is an increased risk for hypoglycemia. (B) Exercise lowers blood sugar levels; therefore, a snack may be needed to maintain the appropriate glucose level. (C) Exercise lowers blood sugar levels. (D) Exercise lowers blood sugar levels. If the blood glucose level is 100 mg or below at the start of exercise, the potential for hypoglycemia is greater.






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