A nurse is caring for a client who has dyspnea with an oxygen saturation of 88%. Which of the following indicates the type of face mask the nurse should use to deliver the client a 90% oxygen concentration?

Simple face mask

Nasal prongs

Non-rebreather mask

Nasal cannula

Answer and Explanation

The Correct Answer is C

A. Simple face mask: This can deliver oxygen at flow rates of 5-10 liters per minute and typically provides an oxygen concentration of about 35-50%.

B. Nasal prongs: Nasal prongs deliver oxygen at lower flow rates and may not be sufficient to raise the client's oxygen saturation to 90%.

C. Non-rebreather mask: This mask can deliver high concentrations of oxygen (up to 90-100%) at flow rates of 10-15 liters per minute. It has one-way valves to prevent the patient from rebreathing exhaled air, thus maximizing the delivery of oxygen.

D. Nasal cannula: Nasal cannulas deliver oxygen at lower flow rates (typically up to 6 liters per minute) and may not provide the necessary concentration to achieve an oxygen saturation of 90%.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Applying talc powder around the stoma can prevent the appliance from adhering properly, leading to leakage. It is not recommended for ostomy care.

B. The skin barrier should be cut to fit closely around the stoma, leaving no more than a 1/8 inch gap, not 1/2 inch. A larger opening may cause skin irritation or leakage.

C. Pressing on the skin barrier for about 30 seconds ensures that it adheres properly to the skin, which helps secure the ostomy appliance and prevents leakage.

D. Moisturizing soap is not recommended for cleaning around the stoma, as it can leave a residue that interferes with the appliance's adhesion. Mild soap without moisturizers or just water should be used.

A. Secure the restraints with a square knot. B. Check the client's range of motion every 6 hr. C. Make sure two fingers fit under the restraints. D. Request a prescription renewal from the provider every 36 hr.

Correct Answer is C

Explanation

A. Securing the restraints with a square knot may be too tight and could restrict circulation or cause injury. Using a quick-release knot is preferable to allow for quick removal if necessary.
B. While it is important to assess the client's range of motion regularly, this action does not directly address the proper application of the restraints.

C. This is the correct action to ensure that the restraints are not too tight, allowing for adequate circulation and preventing injury. The ability to fit two fingers under the restraints ensures that they are applied with proper tension.
D. Requesting a prescription renewal from the provider every 36 hours may be necessary according to facility policy, but it does not directly address the proper application of the
restraints.

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A nurse is caring for a client who has dyspnea with an oxygen saturation of 88%. Which of the following indicates the type of face mask the nurse should use to deliver the client a 90% oxygen concentration?

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