Page 1615 - Saunders Comprehensive Review For NCLEX-RN

Priority Concepts: Client Education; Gas Exchange
Reference: Lewis et al. (2017), pp. 528-529.

579. Answer: 1

Rationale: Silicosis results from chronic, excessive inhalation of particles of free
crystalline silica dust. The client should wear a mask to limit inhalation of this
substance, which can cause restrictive lung disease after years of exposure. Options
2, 3, and 4 are not necessary.
Test-Taking Strategy: Focus on the subject, prevention of silicosis. Recalling that
exposure to silica dust causes the illness and that the dust is inhaled into the
respiratory tract will direct you to the correct option.
Level of Cognitive Ability: Applying
Client Needs: Safe and Effective Care Environment
Integrated Process: Nursing Process—Assessment
Content Area: Adult Health: Respiratory
Health Problem: Adult Health: Respiratory: Environmental
Priority Concepts: Infection; Safety
Reference: Lewis et al. (2017), p. 513.

580. Answer: 4

Rationale: Positions that will assist the client with emphysema with breathing
include sitting up and leaning on an overbed table, sitting up and resting the elbows
on the knees, and standing and leaning against the wall.
Test-Taking Strategy: Eliminate options 1 and 3 first because they are comparable
or alike. Next, eliminate option 2 because this position will not enhance breathing.
Level of Cognitive Ability: Applying
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning
Content Area: Adult Health: Respiratory
Health Problem: Adult Health: Respiratory: Obstructive Pulmonary Disease
Priority Concepts: Client Education; Gas Exchange
Reference: Ignatavicius, Workman, Rebar (2018), pp. 576, 578.

581. Answer: 1, 3, 4, 5

Rationale: Tuberculosis should be considered for any clients with a persistent
cough, weight loss, anorexia, night sweats, hemoptysis, shortness of breath, fever, or
chills. The client’s previous exposure to tuberculosis should also be assessed and
correlated with the clinical manifestations.
Test-Taking Strategy: Note the subject, clinical manifestations of tuberculosis.
Note that headache is not specifically associated with tuberculosis, is not respiratory
in nature, and is not associated with an infection to assist in eliminating this option.
Level of Cognitive Ability: Analyzing
Client Needs: Physiological Integrity
Integrated Process: Teaching and Learning

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