A nurse is caring for a client who is postoperative following a tracheostomy and has copious and tenacious secretions. Which of the following is an acceptable method for the nurse to use to thin this client's secretions?
Provide humidified oxygen.
Prelubricate the suction catheter tip with sterile saline when suctioning the airway.
Perform chest physiotherapy prior to suctioning.
Hyperventilate the client with 100% oxygen before suctioning the airway.
The Correct Answer is A
a. Provide humidified oxygen: Humidification helps prevent the drying of mucous membranes, making secretions more manageable and less tenacious. This is an acceptable method to thin
secretions in a client with a tracheostomy.
b. Prelubricate the suction catheter tip with sterile saline when suctioning the airway: While lubrication with sterile saline is a common practice during suctioning to reduce trauma to the airway, it does not directly address the tenacity of secretions.
c. Perform chest physiotherapy prior to suctioning: Chest physiotherapy is a technique used to mobilize respiratory secretions, but it may not directly address the tenacity of secretions.
d. Hyperventilate the client with 100% oxygen before suctioning the airway: Hyperventilation with 100% oxygen is not a routine practice and may lead to respiratory alkalosis. Providing
humidified oxygen is a more appropriate approach.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is C
Explanation
a. Bile: The guaiac test is not used to detect bile in the stool.
b. Lipids: The guaiac test is not used to detect lipids in the stool.
c. Blood: The guaiac test, also known as the fecal occult blood test (FOBT), is used to detect hidden (occult) blood in the stool. It is commonly used as a screening test for colorectal cancer.
d. Bacteria: The guaiac test is not used to detect bacteria in the stool.
Correct Answer is C
Explanation
a. Weight gain: Hyperthyroidism is more commonly associated with weight loss due to increased metabolism.
b. Constipation: Hyperthyroidism is more likely to cause diarrhea or increased bowel movements.
c. Frequent mood changes: Hyperthyroidism can lead to mood swings, irritability, and anxiety.
d. Sensitivity to cold: Sensitivity to cold is more commonly associated with hypothyroidism, not hyperthyroidism.
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