A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy at 2 L/min via nasal cannula. After assessing the patient, the nurse notes increased drowsiness and a decreased respiratory rate. What is the most appropriate action for the nurse to take?

Increase the oxygen flow rate to 4 L/min to improve oxygenation.

Switch the patient to a non-rebreather mask for better oxygenation.

Continue to monitor the patient closely and reassess in 30 minutes.

Reduce the oxygen flow rate to 1 L/min and notify the healthcare provider.

Answer and Explanation

The Correct Answer is D

A.   Increasing the oxygen flow rate could worsen respiratory depression in patients with COPD, as they rely on low oxygen levels to stimulate breathing.
B.   Switching to a non-rebreather mask could further elevate the oxygen levels and may lead to hypoventilation or respiratory distress.
C.   Monitoring the patient closely and reassessing in 30 minutes might be appropriate if the patient shows no immediate signs of respiratory distress, but the priority is to address the decreased respiratory rate.
D.   Reducing the oxygen flow rate to 1 L/min and notifying the healthcare provider is the most appropriate action, as it may reduce the risk of respiratory depression caused by excessive oxygen.

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Correct Answer is ["B","E","F","G"]

Explanation

A. Positioning the patient supine can increase the risk of aspiration and should be avoided during feeding. The head of the bed should be elevated instead.
B. Monitoring gastric residual volumes is important to assess the tolerance of the feeding and prevent aspiration.
C. Feedings should be given slowly to avoid complications like gastric distention, not rapidly.
D. Using sterile gloves when handling a feeding tube is not necessary unless there is a risk for infection, but clean gloves are generally adequate.
E. Flushing the tube with water before and after medication administration helps to maintain patency and prevent clogging.
F. The head of the bed should be elevated at least 30 degrees during feeding to reduce the risk of aspiration.
G. Verifying tube placement before starting the feeding ensures that the feeding is going into the stomach and not the lungs.

A. Klebsiella pneumoniae B. Streptococcus pneumoniae C. Escherichia coli D. Staphylococcus aureus

Correct Answer is D

Explanation

A. Klebsiella pneumoniae is a Gram-negative bacterium and is typically associated with more severe pneumonia, particularly in patients with underlying lung disease, but it does not form clusters.
B. Streptococcus pneumoniae is a common cause of pneumonia but typically appears as Gram-positive cocci in pairs or chains, not clusters.
C. Escherichia coli is a Gram-negative bacterium that generally causes urinary tract infections and is not a common cause of pneumonia with Gram-positive cocci in clusters.
D. Staphylococcus aureus is a Gram-positive bacterium that forms clusters and is a common cause of pneumonia, particularly in young, otherwise healthy individuals, and can present with fever, chills, and productive cough. This fits the presentation and sputum findings in this patient.

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A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen therapy at 2 L/min via nasal cannula. After assessing the patient, the nurse notes increased drowsiness and a decreased respiratory rate. What is the most appropriate action for the nurse to take?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient receiving enteral nutrition through a nasogastric tube. Which interventions should the nurse implement to ensure safe and effective enteral feeding? (Select All that Apply.)

Correct Answer is ["B","E","F","G"]

Explanation

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Correct Answer is D

Explanation

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