A nurse is reinforcing teaching with a client's family about home oxygen use via nasal cannula. Which of the following statements by a family member indicates an understanding of the teaching?
"We will frequently check the top of his ears for sores."
"We can turn the oxygen up to 10 when he has trouble breathing."
"We can use petroleum jelly to keep his nares moist."
"We will need to remove the nasal cannula when he is eating."
The Correct Answer is A
A. Frequently checking the top of the ears for sores is correct. The nasal cannula tubing can cause pressure injuries behind the ears over time. The family should check for redness or sores and use protective padding or adjust the tubing as needed.
B. Turning the oxygen up to 10 when the client has trouble breathing is incorrect. Oxygen flow rates should be adjusted only as prescribed by the provider. Increasing the flow rate without guidance can lead to complications, such as oxygen toxicity in clients with chronic respiratory conditions.
C. Using petroleum jelly to keep the nares moist is incorrect. Petroleum-based products are flammable and should not be used with oxygen therapy. Instead, a water-based lubricant should be used to prevent nasal dryness.
D. Removing the nasal cannula when eating is incorrect. Clients using a nasal cannula can continue wearing it while eating, as it allows them to receive oxygen continuously. If needed, a healthcare provider can recommend adjustments to oxygen flow during meals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. The grieving process should be complete within 1 year.: This is incorrect. Grief is a highly individual process and does not follow a strict timeline. It can last longer than one year for some individuals, depending on the relationship and circumstances.
B. Anticipatory grieving prolongs the grief process.: This is incorrect. Anticipatory grief, the grief experienced before the loss occurs, does not necessarily prolong the grieving process. In fact, it may help some individuals cope better after the loss because they have already begun to process their emotions.
C. Anger toward the health care staff is expected.: This is correct. It is normal for family members to experience anger during the grieving process, and sometimes they may direct it toward the healthcare staff, especially if they feel that the care is inadequate or if they are overwhelmed by emotions.
D. The stages of grief occur in sequential order.: This is incorrect. While Elisabeth Kübler-Ross identified five stages of grief (denial, anger, bargaining, depression, and acceptance., they do not necessarily occur in a linear or sequential order. Individuals may experience them in different ways and revisit stages at different times.
Correct Answer is B
Explanation
A. Nausea and vomiting: Nausea and vomiting can be present with hypernatremia (high sodium levels), but they are not the most prominent or specific symptom. The client may experience these symptoms, but they are usually accompanied by other signs.
B. Altered mental status: This is a common manifestation of hypernatremia. The elevated sodium level causes an osmotic imbalance, leading to water shifting out of cells, which results in neurological symptoms, including confusion, lethargy, or seizures.
C. Dysrhythmias: Dysrhythmias can occur with electrolyte imbalances, including hypernatremia, but the primary symptoms related to sodium levels are more often neurological in nature, such as confusion or altered mental status, rather than dysrhythmias specifically.
D. Hypothermia: Hypernatremia typically causes an increase in body temperature, not hypothermia. Elevated sodium levels cause dehydration, which could contribute to increased body temperature rather than cooling.
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