A nurse is caring for a client who is conscious and has an airway obstruction.
Which of the following actions should the nurse take?
Tilt the head and lift the chin.
Turn the client to the side.
Begin the Heimlich maneuver.
Perform a blind finger sweep.
The Correct Answer is C
Choice A rationale:
Tilt the head and lift the chin is a technique used to open the airway in an unconscious client, not a conscious one with an airway obstruction.
Choice B rationale:
Turning the client to the side is not the first action to take when a client is conscious and has an airway obstruction.
Choice C rationale:
The Heimlich maneuver is the appropriate action to take for a conscious client who has an airway obstruction. It works by creating an artificial cough, intended to force the obstruction out.
Choice D rationale:
A blind finger sweep should never be performed because it can push the obstruction further into the airway.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Bradycardia, or a slow heart rate, is not typically an early sign of circulatory overload.
Choice B rationale:
Dyspnea, or difficulty breathing, is an early sign of circulatory overload. This occurs because the heart is unable to pump the excess blood effectively, leading to fluid buildup in the lungs.
Choice C rationale:
Flushing, or reddening of the skin, is not typically an early sign of circulatory overload.
Choice D rationale:
Vomiting is not typically an early sign of circulatory overload.
Correct Answer is A
Explanation
Choice A rationale:
Tachycardia, or a rapid heart rate, is a common early sign of hypovolemic shock as the body tries to compensate for the decreased blood volume by increasing the heart rate.
Choice B rationale:
Diminished urine output is a sign of hypovolemic shock, but it is not typically an early sign.
Choice C rationale:
Cold, clammy skin is a sign of hypovolemic shock, but it is not typically an early sign.
Choice D rationale:
Unconsciousness is a late sign of hypovolemic shock, indicating severe blood loss and inadequate perfusion to the brain.
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