The nurse is preparing to administer a narcotic analgesic to a client with a fractured femur who also has obstructive sleep apnea (OSA). Which intervention is most important for the nurse to implement?

Remove dentures or other oral appliance.

Elevate the head of the bed to a 45-degree angle.

Lift and lock the side rails in place.

Apply the client's positive airway pressure device.

Answer and Explanation

The Correct Answer is D

A. Removing dentures or other oral appliances is not directly related to managing obstructive sleep apnea. While it may be necessary for certain procedures or assessments, it does not address the client's OSA during narcotic administration.

B. Elevating the head of the bed to a 45-degree angle is a standard practice to prevent aspiration during narcotic administration, but it does not specifically address the client's obstructive sleep apnea.

C. Lifting and locking the side rails in place is important for client safety but does not directly address the client's obstructive sleep apnea.

D. Applying the client's positive airway pressure (PAP) device is crucial for managing obstructive sleep apnea, especially when administering a narcotic analgesic, which can further depress respiratory function. The PAP device helps maintain airway patency and prevent apneic episodes, reducing the risk of respiratory complications in clients with OSA.

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Correct Answer is B

Explanation

A. Initiating teaching for client care after discharge is incorrect. Teaching, especially initial or comprehensive education, is within the scope of practice of a registered nurse (RN), not a practical nurse (PN).
B. Using bladder ultrasound to detect urinary retention is correct. This is a task within the scope of practice for a PN, as it involves data collection and does not require independent clinical judgment.
C. Completing comprehensive assessments is incorrect. Comprehensive assessments require critical thinking and are the responsibility of the RN. PNs may collect data but do not perform initial comprehensive assessments.
D. Beginning initial sterile wound care for surgical clients is incorrect. The RN should perform the first sterile dressing change postoperatively to assess the wound properly. The PN may perform subsequent dressing changes per facility policy.

A. Blood glucose of 90 mg/dl. (5 mmol/L). B. Potassium level of 4 mEq/L (4 mmol/L) C. Hemoglobin level of 13 g/dL (130 g/L). D. Serum creatinine of 5 mg/dL (442 pmol/L).

Correct Answer is D

Explanation

A. A blood glucose level of 90 mg/dL is within the normal reference range of 74 to 106 mg/dL, so it is not a concern.
B. A potassium level of 4 mEq/L is also within the normal reference range of 3.5 to 5.0 mEq/L, so it does not need to be reported.
C. Although the hemoglobin level of 13 g/dL is below the reference range provided, it is not critically low and may not be urgent unless the patient has symptoms of anemia or other related issues.
D. A serum creatinine level of 5 mg/dL is significantly higher than the normal reference range of 0.5 to 1.1 mg/dL. This indicates renal impairment, which could affect the patient's ability to clear medications used during surgery and could lead to postoperative complications. Therefore, it is crucial to report this finding to the surgeon immediately.

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The nurse is preparing to administer a narcotic analgesic to a client with a fractured femur who also has obstructive sleep apnea (OSA). Which intervention is most important for the nurse to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

Correct Answer is D

Explanation

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