The nurse notifies the healthcare provider of the client's status. The healthcare provider comes to the bedside to evaluate the client.
Which should the nurse do? Select all that apply.

Set up supplemental oxygen delivery

Suggest a different ventilator mode to the provider

Place a nasogastric tube

Increase the fraction of inspired oxygen

Set the ventilator to give mandatory breaths

Gather supplies for extubation

Answer and Explanation

Correct Answer : A,F

A. After successful weaning, the client will need supplemental oxygen via nasal cannula or face mask to ensure continued oxygenation post-extubation.

B. The current weaning process is progressing as expected with pressure support decreasing steadily. There is no indication that a different ventilator mode is necessary at this time.

C. There is no indication in the scenario that the client requires a nasogastric tube for ventilation weaning or extubation.

D. The fraction of inspired oxygen (FiO₂) is currently at 35%, which is appropriate during the weaning process. Increasing FiO₂ without indication could disrupt the weaning progression.

E. The weaning process is designed to gradually reduce support. Adding mandatory breaths would counteract the progress made in reducing ventilatory support.

F. The client has been weaned to minimal ventilatory support, which suggests the healthcare provider may plan for extubation. Having supplies ready will facilitate a smooth extubation process.

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Correct Answer is C

Explanation

A. Sausage and milk may be too rich and could exacerbate diarrhea symptoms.

B. Granola and strawberries contain high fiber, which can worsen diarrhea in some individuals.

C. Oatmeal and banana are both bland foods that can help bulk up stools, making them suitable for someone experiencing diarrhea; herbal tea can help with hydration.

D. Buttered whole wheat toast may be acceptable, but coffee can irritate the gastrointestinal tract and worsen diarrhea.

A. Obtain a portable chest x-ray to verify ETT location. B. Assess for symmetrical chest movement. C. Monitor ETT markings between 22 and 26 cm at teeth line. D. Auscultate for presence of bilateral breath sounds. E. Check for capillary refill of 3 seconds or less.

Correct Answer is ["A","B","D"]

Explanation

A. Obtaining a portable chest x-ray is the gold standard for confirming ETT placement, ensuring the tube is positioned correctly in the trachea and not in the esophagus.

B. Assessing for symmetrical chest movement is important; asymmetry may indicate improper tube placement or lung involvement.

C. Monitoring ETT markings can provide some information about placement, but it is not a definitive method for verifying correct placement since individual anatomy can vary.

D. Auscultating for bilateral breath sounds confirms that air is reaching both lungs, indicating proper ETT placement.

E. Checking capillary refill does not assess ETT placement and is not relevant in this context; the focus should be on respiratory status and tube positioning.

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The nurse notifies the healthcare provider of the client's status. The healthcare provider comes to the bedside to evaluate the client. Which should the nurse do? Select all that apply.

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Naxlex Comprehensive Predictor Exams

Which breakfast selection should the nurse recommend for a 16-year-old with diarrhea?

Correct Answer is C

Explanation

A young adult is brought to the emergency department after taking a handful of drugs. The client is unresponsive, so an endotracheal tube (ETT) is inserted. How should the nurse determine if the ETT is correctly placed? Select all that apply.

Correct Answer is ["A","B","D"]

Explanation

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The nurse notifies the healthcare provider of the client's status. The healthcare provider comes to the bedside to evaluate the client.
Which should the nurse do? Select all that apply.