A nurse is reinforcing teaching with a client's family about home oxygen use via nasal cannula. Which of the following statements by a family member indicates an understanding of the teaching?
"We will frequently check the top of his ears for sores."
"We can turn the oxygen up to 10 when he has trouble breathing."
"We can use petroleum jelly to keep his nares moist."
"We will need to remove the nasal cannula when he is eating."
The Correct Answer is A
A. Frequently checking the top of the ears for sores is correct. The nasal cannula tubing can cause pressure injuries behind the ears over time. The family should check for redness or sores and use protective padding or adjust the tubing as needed.
B. Turning the oxygen up to 10 when the client has trouble breathing is incorrect. Oxygen flow rates should be adjusted only as prescribed by the provider. Increasing the flow rate without guidance can lead to complications, such as oxygen toxicity in clients with chronic respiratory conditions.
C. Using petroleum jelly to keep the nares moist is incorrect. Petroleum-based products are flammable and should not be used with oxygen therapy. Instead, a water-based lubricant should be used to prevent nasal dryness.
D. Removing the nasal cannula when eating is incorrect. Clients using a nasal cannula can continue wearing it while eating, as it allows them to receive oxygen continuously. If needed, a healthcare provider can recommend adjustments to oxygen flow during meals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Ankle is incorrect. The ankle is a hinge joint, which allows for movement in one plane (up and down), not the multidirectional movement characteristic of a ball and socket joint.
B. Shoulder is correct. The shoulder joint is a ball and socket joint. This type of joint allows for movement in multiple directions, including flexion, extension, abduction, adduction, rotation, and circumduction.
C. Knee is incorrect. The knee is a hinge joint, allowing for flexion and extension but not the wide range of motion that a ball and socket joint offers.
D. Metacarpophalangeal is incorrect. The metacarpophalangeal joints (knuckles) are condyloid joints, which allow for movement in two planes but not the full rotational movement of a ball and socket joint.
Correct Answer is C
Explanation
A. Thrombocytopenia: Neither atenolol nor nitroglycerin is commonly associated with thrombocytopenia. This is not the primary concern when these two medications are used together.
B. Dry cough: A dry cough is a known side effect of ACE inhibitors (e.g., enalapril), but it is not commonly associated with atenolol or nitroglycerin.
C. Hypotension: Both atenolol (a beta-blocker) and nitroglycerin (a vasodilator) can lower blood pressure. When taken together, there is an increased risk of hypotension, especially when standing up quickly. The nurse should monitor the client for symptoms of low blood pressure such as dizziness, fainting, or lightheadedness.
D. Hyperglycemia: Atenolol may mask signs of hypoglycemia in clients with diabetes, but it does not directly cause hyperglycemia. Nitroglycerin is not typically associated with hyperglycemia either. Therefore, hyperglycemia is not a concern in this scenario.
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