A nurse caring for a child who is receiving oxygen therapy and is on a continuous oxygen saturation monitor that is reading 89%. Which of the following actions should the nurse take first?

Place the child in the Fowler's position.

Ensure proper placement of the sensor probe.

Increase the oxygen flow rate.

Encourage the child to take deep breaths.

Answer and Explanation

The Correct Answer is B

Choice A reason: While the Fowler's position can aid in breathing, it is not the first action to take if the oxygen saturation monitor is reading low.

Choice B reason: Ensuring the proper placement of the sensor probe is the first step, as incorrect placement can lead to inaccurate readings.

Choice C reason: Increasing the oxygen flow rate should only be considered after confirming the accuracy of the oxygen saturation reading.

Choice D reason: Encouraging deep breaths may be helpful, but it is not the first action to take. The priority is to ensure the oxygen saturation reading is accurate.

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Correct Answer is A

Explanation

Choice A reason: Albuterol is a short-acting beta-2 agonist that is used as a quick-relief medication to prevent exercise-induced bronchoconstriction.

Choice B reason: Prednisone is a corticosteroid used for long-term control, not for immediate relief before exercise.

Choice C reason: Montelukast is a leukotriene receptor antagonist used for long-term control and prevention, not typically for immediate pre-exercise use.

Choice D reason: Fluticasone/salmeterol is a combination of a corticosteroid and a long-acting beta-2 agonist, used for long-term control, not for quick relief before exercise.

A. Ensure that the medication is at room temperature. B. Hyperextend the infant's neck. C. Pull the pinna downward and straight back. D. Hold the infant in an upright position.

Correct Answer is C

Explanation

Choice A reason: Medication should not be cool as it can cause discomfort or even reflexive actions like vomiting or vertigo. It should be at room temperature⁷.

Choice B reason: Hyperextending the infant's neck is not necessary and could be uncomfortable or unsafe. The position should be natural and comfortable⁷.

Choice C reason: Pulling the pinna downward and straight back is the correct method for infants to straighten the ear canal for proper administration of otic medication⁷.

Choice D reason: Holding the infant in an upright position is not ideal for otic medication administration. The infant should be lying down or sitting with the affected ear facing up⁷.

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A nurse caring for a child who is receiving oxygen therapy and is on a continuous oxygen saturation monitor that is reading 89%. Which of the following actions should the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

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