The physician inserted a chest tube drainage to Mr. Alda in order to help re-expand the lungs. Which of the following should you prepare FIRST as a nurse in case of emergency when the tube is accidentally disconnected?

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Question 1 of 5

The physician inserted a chest tube drainage to Mr. Alda in order to help re-expand the lungs. Which of the following should you prepare FIRST as a nurse in case of emergency when the tube is accidentally disconnected?

Correct Answer: A

Rationale: Correct Answer: A - sterile clamps Rationale: 1. **Immediate action**: Sterile clamps are essential to clamp the chest tube to prevent air from entering the pleural space. 2. **Prevent lung collapse**: Clamping the tube will prevent lung collapse and maintain positive pressure in the pleural space. 3. **Buy time**: By clamping the tube, you buy time to properly reattach the tube or secure it with a new connection. 4. **Safety**: Sterile clamps are a quick and effective solution to prevent a potentially life-threatening situation. Summary of other choices: B: Sterile dressing - Not the first priority as the immediate concern is preventing air from entering the pleural space. C: Another chest tube - Not necessary initially as clamping can buy time to reattach the disconnected tube. D: A bottle of sterile water - Not needed for emergency management of a disconnected chest tube.

Question 2 of 5

Annie states,'I 'm afraid to 1et my children out of my sight now that I can't hear them." What is the nurse ' s BEST response?

Correct Answer: A

Rationale: Rationale: A is the correct answer as it demonstrates therapeutic communication by encouraging Annie to express her feelings and fears. It shows empathy and understanding, allowing Annie to elaborate on her concerns. B is incorrect as it dismisses Annie's fears and implies blame on her parenting. C is incorrect as it focuses on the behavior of the children rather than addressing Annie's emotions. D is incorrect as it places the responsibility on the children to make Annie feel comfortable, rather than addressing her concerns directly.

Question 3 of 5

A common chronic complication of diabetes due to the thickening of the capillaries and arterioles of the eye is?

Correct Answer: D

Rationale: The correct answer is D: Diabetic retinopathy. This condition is a common complication of diabetes that occurs due to the thickening of capillaries and arterioles in the eye, leading to damage to the retina. This can result in vision problems and even blindness if left untreated. A: Papilledema is the swelling of the optic disc due to increased intracranial pressure, not related to diabetes. B: Glaucoma is a condition characterized by increased pressure within the eye, not directly caused by diabetes. C: Retinal detachment is the separation of the retina from the underlying tissues, which is not primarily caused by diabetes-related capillary changes.

Question 4 of 5

You should check the patient for suspect disturbed thought processes related to depressed metabolism and altered cardiovascular and respiratory status. What is the rationale for orienting the patient to time, place, date, and events?

Correct Answer: B

Rationale: The correct answer is B: Provides reality orientation to patient. Orienting the patient to time, place, date, and events helps them stay connected to reality and improves their awareness of their surroundings. This is crucial in assessing their cognitive functioning and ensuring they are grounded in the present moment. By providing reality orientation, healthcare providers can better understand the patient's current mental state and address any potential confusion or disorientation. This approach aids in establishing a therapeutic environment and enhances the patient's overall well-being. Choices A, C, and D do not capture the essence of reality orientation and its significance in maintaining the patient's mental clarity and connection to the present moment.

Question 5 of 5

Which of the following situations will the nurse consider as risks factors for complicated grief?

Correct Answer: B

Rationale: The correct answer is B because the death of a spouse, child, or death by suicide are all significant losses that can lead to complicated grief due to the intensity of emotions and the disruption of daily life. These experiences can result in prolonged and severe grieving processes that may require professional intervention. Explanation for other choices: A: Childbirth, marriage, and divorce are not typically considered risk factors for complicated grief as they are more commonly associated with expected life events that may involve grief but not necessarily lead to complicated grief. C: Inadequate perception of the grieving process may contribute to difficulties in coping with grief but is not a direct risk factor for complicated grief. D: While inadequate support can impact the grieving process, and old age may present unique challenges, they are not specific risk factors for complicated grief compared to the profound loss experienced in choice B.

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