The nurse instructing the patient to perform forceful exhalation coughing would instruct the patient to take in:
two deep breaths, then inhale deeply again and force out the air quickly.
one deep breath and quickly exhale
one breath, hold it for 3 seconds, then forcefully exhale three times with mouth open
two breaths and force the air out quickly
The Correct Answer is A
A. Two deep breaths, then inhale deeply again and force out the air quickly: This technique helps clear mucus by mobilizing it toward the larger airways for expulsion.
B. One deep breath and quickly exhale: This method is less effective in mobilizing secretions compared to multiple preparatory breaths.
C. One breath, hold it for 3 seconds, then forcefully exhale three times with mouth open: Holding the breath promotes mucus loosening, and repeated exhalations help clear secretions. While this technique can be correct in some protocols, it is less common for "forceful" cough instructions and may not be the preferred method.
D. Two breaths and force the air out quickly: Lacks the preparatory deep breath necessary for effective secretion clearance.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Choose a wool blanket when using oxygen. Wool and synthetic fabrics can generate static electricity, which is a fire hazard in the presence of oxygen.
B) Keep oxygen tanks 4 feet away from an electric stove. Oxygen tanks should be kept at least 8 to 10 feet away from heat sources, including electric stoves.
C) Store oxygen tanks upright. Oxygen tanks should always be stored upright and secured to prevent them from falling and causing injury or damage.
D) Use petroleum-based ointments to moisturize lips. Petroleum-based products are flammable and should be avoided when using oxygen. Water-based moisturizers are safer.
Correct Answer is A
Explanation
A. Use a 14-Fr catheter: This is the appropriate size for suctioning an adult to effectively remove thick secretions.
B. Use suction pressure between 120 and 160 mm Hg: This pressure is too high and may cause mucosal damage; 100 to 120 mm Hg is recommended for adults.
C. Use an 8-Fr catheter: This size is too small for effectively suctioning thick secretions in adults.
D. Use the catheter to suction the mouth and nasopharynx: Suctioning the mouth first contaminates the catheter, increasing the risk of infection in the nasopharynx.
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