48. A nurse is preparing to provide tracheostomy care to a client who has a chronic tracheostomy.
In which order should the nurse complete the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Pour 2.54 cm (1 in) of 0.9% sodium chloride solution into the sterile basin.

Unlock and remove the inner cannula.

Scrub the inside and outside of the inner cannula with a small brush.

Wipe the inside of the inner cannula with a folded pipe cleaner.

Cleanse the stoma site with 0.9% sodium chloride solution.

Answer and Explanation

The Correct Answer is A,B,C,D,E

Pouring 0.9% sodium chloride solution into the sterile basin provides the solution necessary for cleaning the inner cannula.

Unlocking and removing the inner cannula is the first step in the process of tracheostomy care.

Scrubbing the inside and outside of the inner cannula with a small brush helps remove secretions and debris.

Wiping the inside of the inner cannula with a folded pipe cleaner further cleans the inner surfaces.

Cleansing the stoma site with 0.9% sodium chloride solution completes the tracheostomy care procedure.

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Correct Answer is A

Explanation

A. Nail polish can interfere with the accuracy of pulse oximetry readings by absorbing or

reflecting light, leading to falsely low oxygen saturation readings. It's essential to remove nail polish or acrylic nails from the finger used for pulse oximetry to obtain accurate results.
B. While an elevated hemoglobin level may affect the oxygen-carrying capacity of the blood, it does not directly influence the accuracy of pulse oximetry readings.

C. Fever may affect oxygen saturation levels indirectly by increasing metabolic demand or
respiratory rate, but it does not directly interfere with the accuracy of pulse oximetry readings.
D. Wearing a ring does not typically interfere with pulse oximetry readings unless the ring is very tight and impairs blood flow to the finger. However, nail polish is a more significant
concern for accurate readings.

A. To a family member when the client is not available B. To an employer for a pre-employment screening C. To an insurance agency in regard to a life insurance policy D. To a medical interpreter service on behalf of a client

Correct Answer is D

Explanation

A. Confidential health information should not be disclosed to family members without the

client's consent unless there is a legal or ethical obligation to do so, such as in cases of imminent harm or emergency situations.
B. Health information should not be disclosed to an employer without the client's consent unless required by law or for specific occupational health purposes.

C. Health information should not be disclosed to an insurance agency without the client's consent unless required by law or for specific insurance-related purposes.
D. Health information may be disclosed to a medical interpreter service as necessary to facilitate communication between the client and healthcare providers. However, the interpreter should be informed of confidentiality obligations.

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48. A nurse is preparing to provide tracheostomy care to a client who has a chronic tracheostomy. In which order should the nurse complete the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

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A nurse is planning to obtain a client's oxygen saturation. Which of the following might influence the result of this test?

Correct Answer is A

Explanation

A nurse is reinforcing teaching with a group of newly licensed nurses regarding client confidentiality. In which of the following situations can the nurse disclose health information without the client's written consent?

Correct Answer is D

Explanation

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48. A nurse is preparing to provide tracheostomy care to a client who has a chronic tracheostomy.
In which order should the nurse complete the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)