A nurse in the emergency department is assessing a newly-admitted infant. Which of the following findings is an early indication of hypoxemia?
Hypoventilation
Tachypnea
Nonproductive cough
Nasal stuffiness
The Correct Answer is B
Choice A reason: Hypoventilation is a late sign of hypoxemia and is characterized by an abnormally slow breathing rate, reducing oxygen intake and increasing carbon dioxide in the blood.
Choice B reason: Tachypnea, or rapid breathing, is an early sign of hypoxemia as the body attempts to increase oxygen levels by breathing more quickly.
Choice C reason: A nonproductive cough is not directly related to hypoxemia, which is a deficiency in the amount of oxygen reaching the tissues.
Choice D reason: Nasal stuffiness is not a specific indicator of hypoxemia and can be associated with various conditions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Assessing the mouth with a tongue blade is not recommended postoperatively as it can cause discomfort and disrupt the surgical site.
Choice B reason: Removing the packing in the mouth is typically done by a healthcare provider, not immediately postoperatively, to avoid bleeding and protect the repair.
Choice C reason: Placing the infant in an upright position is recommended to facilitate breathing and reduce swelling⁷.
Choice D reason: Offering a pacifier with sucrose is not advisable as it can interfere with the healing of the cleft repair⁷.
Correct Answer is B
Explanation
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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