The practical nurse (PN) observes a client's mouth and lips as seen in the picture. Which follow-up action is most important for the PN to take?
Ask about pain.
Provide mouth care.
Offer fluids.
Administer oxygen.
The Correct Answer is D
A. Ask about pain. This is not the most important action because pain is not the primary problem in this situation. Pain may or may not be present, but it does not address the underlying cause of cyanosis.
B. Provide mouth care. This is not the most important action because mouth care does not improve oxygenation. Mouth care may be helpful to prevent infection and promote comfort, but it is not a priority in this case.
C. Offer fluids. This is not the most important action because fluids do not increase oxygen levels in the blood. Fluids may be beneficial to prevent dehydration and maintain circulation, but they are not urgent in this scenario.
D. Administer oxygen. This is the most important action because oxygen is essential for cellular function and survival. Oxygen therapy can reverse hypoxia and improve the client's condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
This statement shows awareness but doesn't necessarily indicate acceptance of the prognosis. B. Acceptance is often linked with finding emotional support, and this statement implies the client has found solace and support from faith and family, reflecting a level of acceptance. C. This statement suggests a disbelief or denial of the diagnosis, which is not indicative of acceptance.
D. This statement reflects resistance and denial rather than acceptance of the prognosis. Acceptance usually involves acknowledgment and finding ways to cope positively, which is not shown in this statement.
Correct Answer is A
Explanation
A. Contacting the healthcare provider to clarify the prescription is essential to ensure the correct dosage for the child. It allows for immediate resolution and prevents potential harm from an incorrect dosage.
B. Requesting verification from the charge nurse might be helpful but doesn’t address the issue of the potentially incorrect prescription dosage.
C. Instructing the pharmacy to send an accurate child's dosage is a good step after clarification but doesn't address the immediate concern of the potentially incorrect prescription.
D. Asking another nurse about the administration of adult dosages to children is relevant, but the immediate action should be clarifying the prescription directly with the healthcare provider.
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