A nurse is caring for a client who is having difficulty breathing. The client is lying in bed and is already receiving oxygen therapy via nasal cannula. Which of the following interventions is the nurse's priority?

Assist the client to Fowler's position

Promote removal of pulmonary secretions

Increase the oxygen flow

Obtain a specimen for arterial blood gases

Answer and Explanation

The Correct Answer is A

A. Assist the client to Fowler's position: This position helps maximize lung expansion, making it easier for the client to breathe.
B. Promote removal of pulmonary secretions: Important but secondary to addressing immediate respiratory distress.
C. Increase the oxygen flow: This should only be done per provider order to avoid complications such as oxygen toxicity.
D. Obtain a specimen for arterial blood gases: This is a diagnostic step but not an immediate intervention for difficulty breathing.

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Correct Answer is D

Explanation

A. Loop the client's tubes carefully to prevent kinking: Tubes should not be unnecessarily looped, as this may cause obstruction or tension.
B. Clamp the tube when the client is ambulating: Clamping increases the risk of tension pneumothorax and should be avoided unless prescribed for specific procedures.
C. Place the client flat to avoid leaks in the tubing: This position may compromise lung expansion; semi-Fowler’s or Fowler’s position is preferred.
D. Keep the collection device below the client’s chest level: This position uses gravity to prevent backflow of fluid or air into the pleural space.

A. A nasal cannula B. A Venturi mask C. A humidifier D. High oxygen flow rate

Correct Answer is C

Explanation

A. A nasal cannula: May cause further nasal irritation and is not ideal for patients with sinus disorders.
B. A Venturi mask: Provides precise oxygen delivery but does not address sinus-related discomfort.
C. A humidifier: Helps add moisture to the oxygen, reducing nasal and sinus irritation and improving comfort.
D. High oxygen flow rate: High flow rates without humidification exacerbate sinus irritation.

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A nurse is caring for a client who is having difficulty breathing. The client is lying in bed and is already receiving oxygen therapy via nasal cannula. Which of the following interventions is the nurse's priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the care of a client who has a newly inserted chest tube. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

A patient who will begin oxygen therapy has a history of sinus disorders. This patient would benefit most from which oxygen setup?

Correct Answer is C

Explanation

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