Question 1

A post-operative patient develops stridor and increasing respiratory distress 6 hours after a total thyroidectomy. What is the nurse's priority action?

Accepted Answer

Notify the surgeon immediately and prepare for emergency airway management, as this indicates laryngeal edema or hematoma compressing the trachea, which is a life-threatening complication.

Question 2

A patient with COPD is admitted with an exacerbation. The nurse notes an oxygen saturation of 88% on room air. What is the priority oxygen delivery target for this patient?

Accepted Answer

Maintain oxygen saturation between 88–92% to avoid suppressing the hypoxic drive, which COPD patients rely on for respiratory stimulus.

Question 3

A patient returns from bronchoscopy and requests a drink of water. What must the nurse assess before allowing oral intake?

Accepted Answer

The nurse must assess the return of the gag reflex, as the throat is anesthetized during bronchoscopy and aspiration risk is high until the reflex returns.

Question 4

A patient with a pneumothorax has a chest tube in place. The nurse notices the water-seal chamber has stopped fluctuating (tidaling). What does this most likely indicate?

Accepted Answer

Cessation of tidaling most likely indicates that the lung has fully re-expanded, though it may also indicate a kinked or obstructed chest tube, which must be ruled out.

Question 5

Which assessment finding in a patient with a pulmonary embolism requires the nurse's most immediate intervention?

Accepted Answer

Sudden onset of severe hypoxia with oxygen saturation below 90%, tachycardia, and hypotension indicates a massive PE causing hemodynamic instability, requiring immediate emergency response.

Med-Surg Priorities: NCLEX-RN Flashcards

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