Nokea
A client has an oxygen saturation of 88% on room air. Which action should the nurse take first?
- A. Initiate oxygen therapy at 2 liters per minute via nasal cannula.
- B. Place the client in a high-Fowler's position.
- C. Notify the healthcare provider.
- D. Document the finding in the client's medical record.
Correct Answer: A
Rationale: The correct answer is A: Initiate oxygen therapy at 2 liters per minute via nasal cannula. Oxygen saturation of 88% indicates hypoxemia and requires immediate intervention. Providing supplemental oxygen via nasal cannula will help improve oxygenation. Placing the client in high-Fowler's position may help with ventilation but addressing hypoxemia is the priority. Notifying the healthcare provider is important but immediate intervention is necessary. Documenting the finding is important but should not delay providing oxygen therapy.
You may also like to solve these questions
What health hazard is significant, particularly to patients with asthma?
- A. Alcoholism
- B. Asthma
- C. Peptic ulcer
- D. Peripheral vascular disease
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What activity would the nurse have to help Mr. Singer modify?
- A. Eating
- B. Walking
- C. Sleeping
- D. Bathing
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Although acute pain is severe, why does a client with acute pain cope better with the discomfort in the later stages?
- A. Because the pain is negligible in the later stages.
- B. Because an increased dosage of analgesics is used in the later stages.
- C. Because the client’s perception of pain minimizes in the later stages.
- D. Because there is a reinforcing belief that the pain will resolve in time.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A client is prescribed albuterol (Proventil) via a metered-dose inhaler. Which action should the nurse take to ensure effective use of this medication?
- A. Instruct the client to inhale quickly while administering the medication.
- B. Have the client hold their breath for 10 seconds after inhaling the medication.
- C. Tell the client to exhale immediately after inhaling the medication.
- D. Encourage the client to use the inhaler as needed only when experiencing symptoms.
Correct Answer: B
Rationale: The correct answer is B: Have the client hold their breath for 10 seconds after inhaling the medication. This action promotes medication deposition in the lungs by allowing the albuterol to reach deeper into the airways. Holding the breath for 10 seconds ensures better absorption and effectiveness of the medication.
Explanation of Incorrect Choices:
A: Inhaling quickly may cause the medication to not reach the lower airways effectively.
C: Exhaling immediately after inhaling the medication can decrease the amount of medication reaching the lungs.
D: Using the inhaler only when experiencing symptoms may lead to ineffective management of respiratory conditions.
What should the nurse closely monitor for in a client who has undergone surgery for otosclerosis?
- A. Hypotension
- B. Nausea and vomiting
- C. Decreased urine output
- D. Abnormal facial nerve function
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.