While reading a physician's progress notes a student notes that an assigned client is having hypoxia. What abnormal assessments would the student expect to find?

Diarrhea, flatulence, decreased turgor

Dyspnea, tachycardia, cyanosis

Hypotension, edema, erythema

Chest pain, dry skin, petechiae

Answer and Explanation

The Correct Answer is B

A.   Diarrhea, flatulence, and decreased turgor are not typically associated with hypoxia.
B.   Hypoxia manifests with dyspnea (difficulty breathing), tachycardia (increased heart rate), and cyanosis (bluish discoloration of the skin).
C. Hypotension, edema, and erythema are not primary signs of hypoxia.
D.   Chest pain, dry skin, and petechiae are not specific to hypoxia.

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Correct Answer is B

Explanation

A. Occluding the Y-port during insertion is not a standard practice and may impede proper suctioning.
B. Limiting the application of suction to 20-30 seconds helps prevent hypoxia and tissue damage.
C. Assisting the client into a supine position is not a standard practice for endotracheal tube suctioning.
D. Using sterile saline to moisten the end of the suction catheter may introduce unnecessary moisture into the airway.

A. The helping relationship, orientation phase, working phase, termination phase B. Nursing Process, assess, diagnose, plan, implement, evaluate C. SBAR, situation, background, assessment, recommendation. D. CUS, I am concerned, I feel uncomfortable, this is unsafe.

Correct Answer is D

Explanation

A. The helping relationship phases and nursing process are not specific communication tools for addressing safety concerns.
B. The nursing process is a systematic approach to patient care but is not a communication tool specifically for addressing safety concerns.
C. SBAR (Situation, Background, Assessment, Recommendation) is a structured communication tool commonly used in healthcare settings for reporting and addressing safety concerns.
D. CUS (I am concerned, I feel uncomfortable, this is unsafe) is a communication tool for expressing concerns, for instance, by saying something like this: "I am concerned about the patient's risk for falls. I feel uncomfortable seeing you walk the patient without a gait belt or non-skid socks. This is unsafe for the patient and could cause harm or injury. Please use a gait belt and non-skid socks when walking the patient." This way, the nurse can convey their message in a clear, respectful, and assertive way, and prompt the UAP to take action to ensure the patient's safety.

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While reading a physician's progress notes a student notes that an assigned client is having hypoxia. What abnormal assessments would the student expect to find?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse has received an order to suction a patient's endotracheal tube. Which action is most appropriate when performing this intervention?

Correct Answer is B

Explanation

Correct Answer is D

Explanation

A nurse is feeding a patient who is experiencing dysphagia and requires thickened liquids to prevent from aspirating. Which nursing consideration would be a priority for the nurse to initiate while feeding this patient on a dysphagia diet with thickened liquids?

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The nurse is educating a post-surgical client on methods to decrease the risk of atelectasis. Which of the following would be most important for the nurse to include in this teaching?

In caring for a client experiencing acute hypoxia, the nurse should prepare interventions to help the client for what other condition?

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