A nurse is teaching a newly licensed nurse about a nonrebreather oxygen mask. Which of the following instructions should the nurse include?
Use a nonrebreather mask to deliver low-flow oxygen
A nonrebreather mask should fit snugly over a client's face.
The reservoir bag on a nonrebreather mask should collapse with
A nonrebreather mask dries a client's mucous membranes
The Correct Answer is B
A. A nonrebreather mask is used to deliver high-flow oxygen, not low-flow. It provides the highest concentration of oxygen compared to other types of masks, which is crucial for patients with severe hypoxemia. The high-flow oxygen helps in achieving a higher concentration of oxygen in the blood.
B. It is essential that a nonrebreather mask fits snugly over the client's face to ensure that the patient receives the maximum amount of oxygen and to prevent room air from mixing with the oxygen being delivered. A proper seal is necessary to achieve the desired level of oxygenation and to avoid oxygen leakage.
C. The reservoir bag on a nonrebreather mask should not collapse with each breath. Ideally, the bag should remain partially inflated even during inspiration. If the bag collapses completely, it indicates that the patient is not receiving enough oxygen, and the mask may not be functioning correctly.
D. A nonrebreather mask itself does not cause drying of the mucous membranes. However, high-flow oxygen can sometimes lead to dryness of the mucous membranes if not managed properly. Humidification may be required to prevent dryness, but this is not a direct effect of the mask itself.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. While asking appropriate questions demonstrates that the partner is engaged and seeking understanding, it alone does not indicate that they are ready to perform the procedure independently.
B. Being able to verbalize all steps in the procedure shows that the partner has knowledge and understanding of the process. However, verbalizing alone does not confirm that they can perform the procedure accurately and safely. Practical skills and hands-on competence are crucial for readiness.
C. Attending a class provides important theoretical knowledge and information about tracheostomy care. However, attending a class by itself does not guarantee that the partner has developed the necessary skills to perform suctioning independently.
D. The ability to perform the procedure independently indicates that the partner has acquired the necessary skills and confidence to carry out suctioning safely and effectively. It shows practical proficiency, which is essential for readiness for discharge. The partner’s ability to perform suctioning without assistance demonstrates that they can handle the procedure in real-life situations.
Correct Answer is B
Explanation
A. While administering 0.9% sodium chloride is an important step to maintain venous access and to help dilute any blood that might still be in the tubing, it is not the first action to take if a transfusion reaction is suspected. This step should occur after the transfusion is stopped and the patient’s safety is ensured.
B. The immediate priority when a transfusion reaction is suspected is to stop the transfusion immediately. This action helps to prevent further exposure to the potentially harmful blood product and mitigates the risk of worsening the reaction. Stopping the transfusion also allows for prompt medical assessment and intervention.
C. Returning the unit of blood to the blood bank is important for investigation and to determine the cause of the reaction, but it should be done after stopping the transfusion and ensuring the client’s safety. The blood bank may require the returned unit to confirm any issues with the blood product.
D. Obtaining a blood sample from the client is crucial for diagnostic purposes and to identify the cause of the reaction, but this should be done after the transfusion has been stopped. The sample may help in diagnosing the type of reaction or in managing it, but it does not address the immediate safety concerns.
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