問題一覧
1
What is the most important safety issue related to oxygen administration, that the nurse should consider?
Oxygen allows common flammable materials to burn faster and hotter.
2
The nurse is explaining to a client diagnosed with cystic fibrosis the goals of the oxygen therapy being prescribed. Which is a therapeutic effect of oxygen administration?
It decreases the heart's work in pumping blood and eases the heart's load.
3
The nurse administering oxygen to clients with respiratory disorders is careful to monitor concentrations to prevent oxygen toxicity. How does this adverse reaction manifest itself?
Changes in lung tissue
4
A nurse is caring for a newborn receiving 100% oxygen for resuscitation through an oxygen mask. What potential complication is of most concern for in this client?
Vision difficulties
5
A client after cardiac arrest is receiving oxygen therapy via a mask. What unit should the nurse use to document the amount of oxygen delivered?
Liters per minute
6
The nurse is using a pulse oximeter to determine the percentage of oxygen saturation in a client's blood. Which pulse oximetry reading indicates that the client needs immediate supplemental oxygen?
85%
7
A nurse is caring for a client receiving oxygen from a large oxygen cylinder. What measure should the nurse implement to minimize the risk of injury?
Ensure that the cylinder is always kept away from heat.
8
A nurse is caring for a client receiving oxygen through a portable liquid-oxygen stroller. What measure should the nurse implement when operating the stroller?
Take measures to keep the stroller upright at all times.
9
The nurse is preparing to discharge a client who is on supplemental oxygen to his home. Which oxygen delivery system is widely used in home care settings for its safety and convenience?
Concentrator
10
The nurse knows that when administering oxygen to an individual who is having difficulty breathing, the type of device that is used is critically important. What is the primary concern when delivering oxygen to a client?
Delivery of desired concentration
11
A nurse is caring for a client who has been ordered oxygen using a nasal cannula. What care should the nurse take to ensure client comfort?
Attach the humidifier to the flow meter.
12
The nurse is using a simple mask on a client prescribed supplemental oxygen. What is the minimum oxygen flow rate for oxygen delivery using a simple mask to prevent carbon dioxide buildup?
6 LPM
13
The nurse is selecting an oxygen mask for a client diagnosed with pneumonia who requires an oxygen concentration of 75% with a flow rate around 10 LPM. Which mask would be a good choice for this client?
Partial-rebreathing mask
14
A nurse is caring for a client receiving oxygen through a non-rebreathing mask (NRM). What measure should the nurse employ when caring for the client?
Avoid leaving a client alone while they are wearing an NRM.
15
A nurse is caring for a client diagnosed with chronic obstructive pulmonary disease (COPD) receiving supplemental oxygen through a Venturi mask. What measure should the nurse employ when caring for this client?
Ensure that the windows of the mask remain exposed to room air.
16
A nurse is applying an oxygen mask for a client diagnosed with chronic obstructive pulmonary disease (COPD) that provides the most reliable and consistent oxygen enrichment. Which mask has the nurse chosen?
Venturi mask
17
Intermittent positive pressure breathing (IPPB) treatments are prescribed for a young client diagnosed with cystic fibrosis. What is the goal of IPPB?
Liquefy mucus
18
The nurse caring for clients in the ICU notices that a client is not breathing. What should be the immediate nursing intervention for this client?
Call for assistance
19
The nurse has assisted with the intubation of a client diagnosed with status asthmaticus. What should the nurse do to verify proper placement of the endotracheal tube (ET)?
Obtain a chest x-ray.
20
What condition might occur if an endotracheal tube (ET) is incorrectly placed?
Gastric distention
21
The nurse is caring for a client who is intubated following trauma to the chest. Which nursing measures should the nurse perform while the client is intubated? Select all that apply.
Monitor placement of the endotracheal tube.
22
The nurse is teaching a student nurse the use of mechanical ventilators for clients in ventilatory failure. Which teaching point regarding this procedure is accurate?
A mechanical ventilator is a machine that can be connected to the client via an endotracheal tube (ET).
23
The respiratory therapist explains to the nurse that the positive pressure ventilator pushes air into the lungs of a client through a circuit that joins the machine and the client. Which mode of operation breathes for the client, forcing a breath at set time intervals?
Controlled-breath ventilation
24
Which client would most likely require chronic mechanical ventilation?
client who has a spinal cord injury
25
The nurse is facilitating the weaning of a client from mechanical ventilation. The nurse uses ventilation that allows inspiratory and expiratory airway pressures to be maintained above atmospheric pressure and helps keep the client's lungs inflated. This method tends to improve lung function, even though breathing is spontaneous. What is the term for this mode of ventilation?
Continuous positive airway pressure (CPAP).
26
A nurse is caring for an unconscious client who has undergone a tracheostomy. What measure should the nurse take while suctioning this client?
Avoid applying suction when inserting the suction catheter.
27
A nurse is caring for a client receiving mechanical ventilation through a tracheostomy tube. What measure should the nurse employ with this client?
Perform tracheal suctioning, as needed.
28
nurse is caring for a client who underwent a tracheostomy following throat surgery. What is the rationale for swabbing the area around the outside of the tracheostomy tube with hydrogen peroxide?
To remove encrusted secretions ventilation.