A nurse in a long-term care facility sees a client who is choking. Which of the following data should the nurse identify as requiring an abdominal thrust?
The client is grasping his abdomen.
The client is coughing.
The client cannot speak.
The client is hyperventilating.
The Correct Answer is C
A. The client is grasping his abdomen: Grasping the abdomen may indicate pain or cramping, not necessarily airway obstruction.
B. The client is coughing: Effective coughing suggests that the airway is partially open and the client is moving air, meaning abdominal thrusts are not required.
C. The client cannot speak: Inability to speak or cough is a sign of complete airway obstruction, indicating the need for abdominal thrusts.
D. The client is hyperventilating: Rapid breathing is not a typical sign of choking and does not warrant abdominal thrusts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Deliver two quick short breaths into the patient's airway: Rescue breaths are not performed until airway patency and circulation are assessed.
B. Tilt the head by placing one hand on the forehead and lift the chin: This technique opens the airway but should follow calling for help and basic assessment.
C. Call for help or, if there is assistance, have that person get help: Activating emergency services is critical for obtaining additional life-saving resources.
D. Position the fingers over the carotid artery to feel for a pulse: Pulse checks come after calling for help in the Basic Life Support (BLS) algorithm.
Correct Answer is ["A","B","D"]
Explanation
A. Aspirated vomit: Can obstruct the airway or cause aspiration pneumonia, reducing oxygenation.
B. Pulmonary fibrosis: Scarring of lung tissue impairs gas exchange, leading to hypoxia.
C. Hiccoughs: Not associated with hypoxia; they are an involuntary diaphragmatic spasm.
D. High altitude: Decreased atmospheric oxygen levels can result in hypoxia.
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