A nurse is caring for a client who develops an airway obstruction from a foreign body but remains conscious. Which of the following actions should the nurse take first?
Perform a blind finger sweep.
Turn the client to the side.
Insert an oral airway.
Administer the abdominal thrust maneuver.
The Correct Answer is D
Choice A reason: Perform a Blind Finger Sweep
Performing a blind finger sweep is not recommended because it can push the foreign object further into the airway, making the obstruction worse. This method is only advised if the object is clearly visible and can be safely removed without causing further harm.
Choice B reason: Turn the Client to the Side
Turning the client to the side can be helpful in certain situations, such as when the client is unconscious or at risk of vomiting. However, in the case of a conscious client with a foreign body airway obstruction, this action does not directly address the obstruction and is not the first priority.
Choice C reason: Insert an Oral Airway
Inserting an oral airway is typically used to maintain an open airway in an unconscious patient who cannot maintain their own airway. For a conscious client with a foreign body obstruction, this action is not appropriate and could cause further complications.
Choice D reason: Administer the Abdominal Thrust Maneuver
Administering the abdominal thrust maneuver (also known as the Heimlich maneuver) is the recommended first action for a conscious client with a foreign body airway obstruction. This technique involves standing behind the client, placing a fist just above their navel, and delivering quick, upward thrusts to expel the foreign object. This method is effective in creating an artificial cough that can dislodge the obstruction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
Reduced chest width: Aging does not typically result in a reduced chest width. Instead, changes in posture and the curvature of the spine can make the chest appear less prominent. The primary musculoskeletal changes with aging involve bone density, muscle mass, and joint flexibility
Choice B reason:
Increased force of isometric contraction: This is incorrect. Aging is associated with a decrease in muscle strength and mass, not an increase. The force of muscle contractions generally diminishes with age due to the loss of muscle fibers and changes in muscle composition.
Choice C reason:
Decreased muscle mass: This is correct. One of the most significant age-related musculoskeletal changes is sarcopenia, which is the loss of muscle mass and strength. This process begins around the age of 30 and accelerates with age, leading to decreased physical strength and increased risk of falls and fractures.
Choice D reason:
Thickened vertebral discs: Aging typically leads to the thinning and dehydration of intervertebral discs, not thickening. This can result in a reduction in height and increased susceptibility to spinal issues such as herniated discs and spinal stenosis.
Correct Answer is ["D","E"]
Explanation
Choice A reason:
Don sterile gloves: While it is important to maintain cleanliness, sterile gloves are not necessary for administering a suppository. Clean, non-sterile gloves are sufficient to prevent infection and ensure hygiene.
Choice B reason:
Position the client supine with knees bent: The correct position for administering a suppository is the left lateral (Sims) position, not supine with knees bent. The left lateral position allows for easier access to the rectum and helps the suppository stay in place.
Choice C reason:
Use a rectal applicator for insertion: Suppositories are typically inserted using a gloved finger, not a rectal applicator. The gloved finger allows for better control and ensures the suppository is placed correctly.
Choice D reason:
Insert the suppository just beyond the internal sphincter: This is correct. The suppository should be inserted past the internal sphincter to ensure it stays in place and can dissolve properly. This placement helps the medication to be absorbed effectively.
Choice E reason:
Lubricate the index finger: Lubricating the index finger is essential to make the insertion process smoother and more comfortable for the client. It helps prevent trauma to the rectal mucosa and ensures the suppository is inserted easily.
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