A nurse is performing a home safety assessment for a client who is receiving supplemental oxygen. Which of the following observations should the nurse identify as proper safety protocol?

The client uses a wool blanket on their bed.

The client identifies the location of a fire extinguisher.

The client stores an extra oxygen tank on its side under their bed.

The client has a weekly inspection checklist for oxygen equipment.

Answer and Explanation

The Correct Answer is B

A. The client uses a wool blanket on their bed: Wool blankets are flammable and can easily ignite in the presence of oxygen, increasing the risk of fire. Proper oxygen safety protocol requires the client to use nonflammable materials such as cotton or synthetic flame-resistant bedding to minimize ignition hazards.

B. The client identifies the location of a fire extinguisher: Knowing where a fire extinguisher is located is a critical component of home oxygen safety. In the event of an accidental fire, rapid access to an extinguisher can prevent injury or property damage. This proactive identification demonstrates proper safety awareness and preparedness for emergencies.

C. The client stores an extra oxygen tank on its side under their bed: Oxygen tanks must always be stored upright and secured to prevent tipping, rolling, or damage to the cylinder. Storing a tank on its side under a bed is unsafe because it increases the risk of leaks, accidental discharge, or physical injury if the tank falls. Proper storage protocol is essential to maintain safety.

D. The client has a weekly inspection checklist for oxygen equipment: Regular inspection of oxygen equipment is important for safety and functionality; however, a weekly inspection may not be sufficient depending on the client’s usage and manufacturer recommendations. Daily visual checks for leaks, tubing kinks, and tank pressure are considered best practice.

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Correct Answer is A

Explanation

A. "You should have an eye examination every 2 years.": Regular eye exams are recommended for older adults to detect age-related visual changes, such as cataracts, glaucoma, and macular degeneration. A comprehensive eye exam every 1–2 years helps maintain vision, detect disease early, and prevent complications like falls or loss of independence. This is consistent with guidelines from the American Academy of Ophthalmology and the CDC.

B. "You should receive a tetanus booster every 5 years.": For older adults, tetanus boosters are recommended every 10 years, not every 5 years. Administering it more frequently than indicated does not provide additional protection and is unnecessary. Correct timing ensures optimal immunity while avoiding over-vaccination.

C. "You should receive a shingles vaccine when you are 70 years old.": The shingles (herpes zoster) vaccine is recommended for adults aged 50 and older, not at a specific age like 70. Receiving it earlier provides protection against shingles and its complications, such as postherpetic neuralgia. Waiting until age 70 may delay critical preventive care.

D. "You should receive a pneumococcal vaccine when you are 50 years old.": Pneumococcal vaccination recommendations depend on individual risk factors. Routine vaccination is generally advised for all adults aged 65 and older, with earlier vaccination for those with chronic illnesses or immunocompromised status. Recommending it at age 50 for all older adults is not consistent with standard guidelines.

A. The tube aspirate has a pH of 7 (less than 5). B. An x-ray shows the end of the tube above the pylorus. C. Bowel sounds are present on auscultation. D. The client reports relief of nausea.

Correct Answer is B

Explanation

A. The tube aspirate has a pH of 7 (less than 5): Gastric aspirate typically has an acidic pH ranging from about 1 to 5 due to the presence of hydrochloric acid in the stomach. A pH of 7 is neutral and more consistent with respiratory or intestinal secretions rather than gastric contents. Therefore, this finding does not reliably confirm that the NG tube is correctly positioned in the stomach.

B. An x-ray shows the end of the tube above the pylorus: Radiographic confirmation is considered the gold standard for verifying nasogastric tube placement. An x-ray showing the tube tip located within the stomach, above the pylorus, confirms that the tube has not entered the respiratory tract and is positioned appropriately for gastric decompression or feeding. This method provides the most accurate and reliable confirmation of placement.

C. Bowel sounds are present on auscultation: The presence of bowel sounds only indicates intestinal motility and does not provide information about the position of the NG tube. Historically, auscultating for air insufflation (“whooshing” sound) was used to check placement, but this practice is unreliable because similar sounds can occur even when the tube is misplaced in the lungs.

D. The client reports relief of nausea: Symptom relief may occur after gastric decompression but does not confirm correct placement of the tube. A client might experience temporary relief even if the tube is partially misplaced. Objective verification methods such as radiographic confirmation are necessary to ensure safe and correct tube positioning.

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