A nurse is performing nasopharyngeal suctioning for an adult client. Which of the following techniques should the nurse use?

Insert the catheter 10 cm (4 in..

Apply suction while inserting the catheter.

Apply intermittent suction for 30 seconds.

Wait 1 min between suctioning attempts.

Answer and Explanation

The Correct Answer is D

A.   In adults insert catheter approximately 16 cm (6.5 inches); in older children, 8– 12 cm (3–5 inches); in infants and young children, 4–7.5 cm (1.5–3 inches). Rule of thumb is to insert catheter distance from tip of nose (or mouth) to angle of mandible.
B.   Suction should not be applied while inserting the catheter, as it could cause trauma to the mucosa and increase discomfort. Suction should only be applied while withdrawing the catheter, and it should be done intermittently to avoid injury and reduce the risk of hypoxia.
C.   Suctioning should not exceed 10-15 seconds at a time to prevent hypoxia and other complications. Prolonged suctioning can lead to oxygen depletion and potential respiratory distress in the client.
D.   Waiting at least 1 minute between suctioning attempts allows the client to recover and helps maintain adequate oxygenation. This pause is essential to prevent hypoxia and to ensure the client has time to breathe normally before the next suctioning attempt.

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Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"B"}

Explanation

When interpreting test results, particularly for an infectious disease like tuberculosis (TB), the nurse must prioritize specific infection control measures to prevent the spread of the disease.

The correct actions are:

Wear an N95 respirator mask: This mask is essential for protecting the nurse and others from inhaling airborne pathogens that the client with TB might expel.
Place the client in a room with negative air pressure: This type of room ensures that airborne contaminants do not escape into the hallway or other areas, thereby containing the infection and protecting others in the healthcare facility.

These measures are critical in managing the spread of TB and ensuring the safety of both healthcare workers and other patients.

A. Discarding worksheets containing client information in a wastebasket B. Writing a client's diagnosis on the message board in the client's room C. Giving change of shift report to a nurse outside the client's room D. Discussing a client's prognosis with an assistive personnel who is caring for the client

Correct Answer is D

Explanation

A. Discarding worksheets containing client information in a wastebasket does not ensure proper disposal of confidential information and could compromise confidentiality.
B. Writing a client's diagnosis on the message board in the client's room could breach confidentiality, as it could potentially be seen by unauthorized individuals.
C. The best practice is to provide bedside report, which involves the patient in their care and promotes transparency. This approach ensures that the patient's condition and care plan are communicated accurately and directly.
D. Assistive personnel (AP) are part of the care team, and discussing the client's prognosis with them is appropriate as long as they have a need to know the information for providing proper care.

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A nurse is performing nasopharyngeal suctioning for an adult client. Which of the following techniques should the nurse use?

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Naxlex Comprehensive Predictor Exams

The nurse reviews the client's test results. Exhibits Complete the following sentence by using the list of options. The nurse should and

Correct Answer is {"dropdown-group-1":"E","dropdown-group-2":"B"}

Explanation

A nurse is reviewing client confidentiality with other staff members. The nurse should identify which of the following actions is an example of protecting client confidentiality.

Correct Answer is D

Explanation

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