NCLEX Questions Respiratory
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Question 1 of 5.
A patient is receiving continuous IV Heparin for anticoagulation therapy for the treatment of a DVT. In order for this medication to have a therapeutic effect on the patient, the aPTT should be?
A. 0.5-2.5 times the normal value range
B. 2-3 times the normal value range
C. 1.5-2.5 times the normal value range
D. 1-3.5 times the normal value range
Explanation: An aPTT should be 1.5-2.5 times the normal value range for Heparin to achieve a therapeutic effect in a patient to prevent blood clots. If the aPTT is too low, blood clots can form. If the aPTT is too high, bleeding can occur.
Question 2 of 5.
Which information should the nurse teach the client diagnosed with acute sinusitis?
A. Instruct the client to complete all the ordered antibiotics.
B. Teach the client how to irrigate the nasal passages.
C. Have the client demonstrate how to blow the nose.
D. Give the client samples of a narcotic analgesic for the headache.
Explanation: Completing antibiotics (A) ensures treatment of bacterial sinusitis, preventing resistance. Irrigation (B) is supportive, nose-blowing (C) is routine, and narcotics (D) are excessive for sinus headaches.
Question 3 of 5.
The client diagnosed with chronic sinusitis who has undergone a Caldwell-Luc procedure is complaining of pain. Which intervention should the nurse implement first?
A. Administer the narcotic analgesic intravenous push (IVP).
B. Perform gentle oral hygiene.
C. Place the client in semi-Fowler's position.
D. Assess the client's pain.
Explanation: Pain assessment (D) is the first step to determine severity and guide treatment. Narcotics (A), oral hygiene (B), and positioning (C) follow based on assessment.
Question 4 of 5.
Which task is most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?
A. Feed a client who is postoperative tonsillectomy the first meal of clear liquids.
B. Encourage the client diagnosed with a cold to drink a glass of orange juice.
C. Obtain a throat culture on a client diagnosed with bacterial pharyngitis.
D. Escort the client diagnosed with laryngitis outside to smoke a cigarette.
Explanation: Encouraging juice intake (B) is within UAP scope and safe. Feeding post-tonsillectomy (A) risks bleeding, throat cultures (C) require training, and smoking (D) is contraindicated.
Question 5 of 5.
The nurse in a long-term care facility is planning the care for a client with a percutaneous endoscopic gastrostomy (PEG) feeding tube used for bolus feedings. Which intervention should the nurse include in the plan of care?
A. Inspect the insertion line at the naris prior to instilling formula.
B. Elevate the head of the bed (HOB) after feeding the client.
C. Place the client in the Sims position following each feeding.
D. Change the dressing on the feeding tube every three (3) days.
Explanation: Elevating HOB post-feeding (B) prevents aspiration in PEG clients. Naris inspection (A) applies to NG tubes, Sims position (C) is not standard, and dressings (D) are changed PRN.
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