N4 test Interventions for Clients with Oxygen or Tracheostomy

Ignatavicius & Workman: Medical-Surgical Nursing: Critical Thinking for Collaborative Care, 4th Edition Chapter 28: Interventions for Clients with Oxygen or Tracheostomy

1. What is the major advantage of oxygen delivery by nasal cannula over oxygen delivery by simple facemask?
A. The nasal cannula can deliver higher oxygen flow rates and concentrations than can a simple facemask.
B. It is easier to eat and participate in conversation with a nasal cannula than with a facemask.
C. The risk for aspiration is greater with a facemask than it is with a nasal cannula.
D. A mask cannot be used for an unconscious client.

2. The client with chronic lung disease and hypercarbia who is receiving oxygen by nasal cannula at 8 L/min now has a respiratory rate of 8. What is your best action?
A. Document the observation as the only action.
B. Place the client in high Fowler’s position.
C. Change the nasal cannula to a mask.
D. Decrease the rate of oxygen flow.

3. The client receiving oxygen by nasal cannula at 2 L/min has experienced the following changes in the past hour: pulse rate change from 88 bpm to 106 bpm, respiratory rate change from 26/minute to 32/minute, and SaO2 from 92% to 88%. What is your best first action?
A. Document the changes as the only action.
B. Increase the oxygen flow rate to 4 L/min.
C. Change the nasal cannula to a mask.
D. Notify the physician.

4. Which set of arterial blood gas values indicates to you that the oxygen therapy for your 75-year-old client with an acute respiratory problem is not sufficient?
A. pH 7.32, HCO3- 22 mEq/L, PCO2 55 mm Hg, PO2 78 mm Hg
B. pH 7.28, HCO3- 17 mEq/L, PCO2 25 mm Hg, PO2 98 mm Hg
C. pH 7.35, HCO3- 36 mEq/L, PCO2 45 mm Hg, PO2 94 mm Hg
D. pH 7.48, HCO3- 12 mEq/L, PCO2 35 mm Hg, PO2 85 mm Hg

5. Which statement made by the client being discharged on home oxygen therapy indicates a need for further clarification of this therapy?
A. “People shouldn’t smoke in the same room where I am using my oxygen.”
B. “I will call my doctor before increasing the amount of oxygen I am using.”
C. “I will miss going out to dinner and playing cards at the homes of my friends.”
D. “The gas I exhale into the room will not hurt my grandchildren when they are visiting me.”

6. Which statement made by the caregiver of a client with a new tracheostomy being discharged to home indicates the need for clarification about home management?
A. “It is not necessary to use sterile supplies to clean the cannula.”
B. “When suctioning, the mouth is suctioned first then the tracheostomy.”
C. “We will put a shower shield over the tracheostomy during showering or shampooing.”
D. “If the stoma site is red, swollen, or has a discharge, I will call the doctor right away.”

7. Which intervention would you use to prevent aspiration when feeding a client with a new tracheostomy?
A. If the tracheal tube is fenestrated, insert the inner cannula and cap the tube.
B. Keep suctioning equipment at the bedside during mealtimes.
C. Position the client on his or her right side during the meal.
D. Encourage the client to “dry swallow” after each bite.