A nurse is caring for a client who is using a non-rebreather mask for oxygen delivery. The nurse should identify which of the following as an indication that the equipment is functioning properly?
A. Air is heard escaping from around the mask. B. The flow control meter dial is at the correct setting. C. The attached reservoir bag is inflated. D. The exhalation ports are covered during inspiration and expiration.
Answer and Explanation
The Correct Answer is C
A. Air escaping from around the mask indicates a poor mask seal, which would lead to inadequate oxygen delivery and is not an indication of proper equipment function.
B. The flow control meter dial being at the correct setting ensures the appropriate flow rate of oxygen but does not directly indicate the functionality of the mask and reservoir system. C. The attached reservoir bag should be inflated with oxygen when the mask is properly connected and functioning, indicating the delivery of high-concentration oxygen to the client.
D. The non-rebreather mask should not have exhalation ports that are covered during inspiration and expiration; rather, it should allow exhaled air to escape to prevent carbon dioxide buildup within the mask.
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Related Questions
Correct Answer is C
Explanation
A. Cleansing the perineal area from back to front can introduce bacteria from the rectum to the urinary tract, increasing the risk of infection. Front to back is the recommended direction for cleansing.
B. Washing the perineal area with povidone-iodine twice daily may be too frequent and could potentially irritate the area. Gentle cleansing with warm water is typically recommended.
C. Changing the perineal pad with each void helps to maintain cleanliness and prevent infection by reducing the buildup of moisture and bacteria.
D. Wiping the perineal area with a soft towel is appropriate for gentle cleansing but does not address the importance of changing the perineal pad regularly.
Correct Answer is B
Explanation
A. Frequently reminding the client of behavioral expectations may agitate or escalate the client further, as individuals experiencing mania may already have difficulty with impulse control and irritability.
B. Encouraging the client to participate in a group activity can help redirect excess energy and provide a structured outlet for social interaction. Group activities can also help decrease isolation and provide opportunities for the client to engage in appropriate behaviors.
C. Allowing the client to pick her own clothing is generally appropriate and promotes autonomy, but it may not directly address the symptoms of mania.
D. While physical activity can be beneficial for individuals with bipolar disorder, encouraging increased physical activity during a manic episode may exacerbate symptoms or lead to overexertion.
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