A nurse is providing discharge teaching for a client who requires home oxygen therapy. Which of the following statements should the nurse identify as an indication that the client needs further teaching?

"I will wear synthetic clothing and woolen socks when using my oxygen.”

"I will make sure my visitors smoke outside.”

"I will be able to tell how much oxygen I'm getting by looking at the flowmeter.”

"I should call my doctor if I find it harder to concentrate.”

Answer and Explanation

The Correct Answer is A

Choice A rationale:

This statement indicates a need for further teaching. Synthetic clothing and woolen socks can generate static electricity, which poses a risk around oxygen due to its flammable nature. The client should be advised to wear cotton clothing and avoid synthetic fabrics to prevent static-related accidents.

Choice B rationale:

This statement is correct. Oxygen supports combustion, so ensuring visitors don't smoke near the client is crucial. However, it does not indicate a need for further teaching.

Choice C rationale:

This statement is incorrect. The client cannot determine the oxygen flow rate by visual inspection of the flowmeter. The flow rate should be set based on the healthcare provider's instructions, and this information should have been covered in the teaching.

Choice D rationale:

This statement indicates the client understands the potential cognitive effects of oxygen therapy and when to seek medical assistance. It does not necessarily indicate a need for further teaching.

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Correct Answer is C

Explanation

Choice A rationale:

Justice. Justice refers to fair and equitable treatment for all individuals. While it is an important ethical principle, it does not directly relate to the nurse's action of returning a telephone call promptly and as promised. Justice involves issues of fairness and distribution of resources, and it's not the most applicable principle in this context.

Choice B rationale:

Nonmaleficence. Nonmaleficence refers to the principle of "do no harm." While it is crucial in healthcare, it doesn't directly address the nurse's action of returning a client's call promptly. This principle is more concerned with preventing harm in clinical interventions and decision-making.

Choice C rationale:

Fidelity. Fidelity, or faithfulness, is the ethical principle that aligns with the nurse's action in this scenario. By returning the call by the end of the day as promised, the nurse is demonstrating fidelity to the client's trust and expectations. This principle emphasizes the importance of keeping promises and being loyal to commitments made to clients.

Choice D rationale:

Autonomy. Autonomy pertains to an individual's right to make their own decisions about their care and treatment. While autonomy is a vital principle in healthcare, it does not directly relate to the nurse's action of returning a telephone call promptly. Autonomy focuses more on involving the client in their care decisions and respecting their choices.

A. Place the client in a modified Trendelenburg position. B. Apply a tourniquet just above the wound. C. Start two large-bore IV catheters. D. Apply pressure directly to the wound.

Correct Answer is D

Explanation

Choice A rationale:

Placing the client in a modified Trendelenburg position is not the first intervention for a client with a deep laceration and heavy bleeding. This position involves tilting the patient with the head lower than the feet and is typically used to improve venous return in certain situations, such as hypovolemic shock. However, for a bleeding wound, the priority is to control the bleeding itself.

Choice B rationale:

Applying a tourniquet just above the wound is a drastic measure and is generally not the first intervention for controlling bleeding. Tourniquets are used when direct pressure and other methods are unsuccessful, as they can lead to complications such as tissue damage and ischemia if not used correctly.

Choice C rationale:

Starting two large-bore IV catheters is important for fluid resuscitation in cases of significant bleeding. However, it is not the first intervention. Directly controlling the bleeding takes precedence to prevent further blood loss.

Choice D rationale:

Applying pressure directly to the wound is the correct answer. This is the initial and immediate action to take when dealing with a heavily bleeding wound. Applying pressure helps to stem the bleeding by promoting clot formation and reducing blood loss. It is a vital step in managing the client's condition and preventing further deterioration.

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A nurse is providing discharge teaching for a client who requires home oxygen therapy. Which of the following statements should the nurse identify as an indication that the client needs further teaching?

Nursing Test Bank

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