A nurse is assisting in the care of a client who has pneumonia.
The nurse is reinforcing discharge teaching with the client and their caregiver. Which of the following information should the nurse include?
Select all that apply.
Store the oxygen cylinder wrench with the oxygen tank.
Take steroid medication in the morning.
Decrease the steroid dose each day.
Take antibiotic medication with or without food.
Adjust the oxygen flow rate as needed to ease breathing.
Ensure the oxygen delivery system
Take antibiotics for 10 days.
Correct Answer : A,B,D,F
A. Store the oxygen cylinder wrench with the oxygen tank.: The wrench is necessary to open the oxygen tank in an emergency or when changing tanks. Keeping it with the tank ensures it is immediately available for the client or caregiver.
B. Take steroid medication in the morning.: Prednisone (a corticosteroid) can cause insomnia and restlessness. Taking it in the morning aligns with the body's natural circadian rhythm of cortisol production and helps prevent sleep disturbances.
C. Decrease the steroid dose each day.: The prescription states "40 mg PO daily for 5 days." The nurse should instruct the client to take the full dose as prescribed. While steroids are often tapered, the client should not self-taper unless specifically directed by the provider's prescription.
D. Take antibiotic medication with or without food.: Cephalexin can be taken without regard to meals. However, if the medication causes GI upset, taking it with food can help mitigate nausea.
E. Adjust the oxygen flow rate as needed to ease breathing.: Oxygen is considered a medication. The client must maintain the prescribed flow rate (3 L/min) and should never adjust it without a provider's order, as excessive oxygen can be harmful to some patients.
F. Ensure the oxygen delivery system is at least 8 feet from any heat source.: Oxygen supports combustion. To prevent fires, tanks and concentrators must be kept away from open flames, space heaters, candles, or gas stoves. Standard safety guidelines usually recommend 5 to 10 feet (8 feet is a safe middle ground).
G. Take antibiotics for 10 days.: The prescription specifically states "every 6 hr for 5 days." Taking medications for longer than prescribed is incorrect instruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Tongue depressor: This is typically used for oral examinations or as a splint for small digits, not for wound assessment.
B. Syringe: While a syringe might be used for wound irrigation, it is not the primary tool for collecting data or measuring the wound's physical characteristics.
C. Cotton-tipped applicator: A stage 4 pressure injury involves full-thickness tissue loss with exposed bone, tendon, or muscle. A cotton-tipped applicator is used to measure the depth of the wound and to check for tunneling or undermining.
D. Adhesive tape: This is used to secure a dressing but does not assist in the data collection/assessment of the wound itself.
Correct Answer is A
Explanation
A. "You are concerned that you are dying?": This is a therapeutic communication technique known as restating or reflecting. It acknowledges the client’s feelings and encourages them to further express their thoughts and fears.
B. "It is normal to feel this way with your type of cancer.": This is a non-therapeutic response that minimizes the client's unique feelings and uses a cliché to generalize their experience.
C. "Why do you think you are dying?": Asking "Why" questions is non-therapeutic as it can make the client feel defensive and puts them on the spot to provide a logical explanation for an emotional state.
D. "I think you should have some quiet time to get some rest.": This is an avoidant response that shuts down communication and dismisses the client's attempt to discuss their end-of-life concerns.
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