What is the most important intervention for a client with an obstructed airway?

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Question 1 of 5

What is the most important intervention for a client with an obstructed airway?

Correct Answer: A

Rationale: The correct answer is A: Administer oxygen. This is the most important intervention for a client with an obstructed airway because it helps to ensure that the patient is receiving adequate oxygen supply to prevent hypoxia. Oxygen therapy can help maintain oxygen saturation levels and support proper gas exchange in the lungs. Monitoring respiratory rate (B) is important but not as critical as ensuring oxygen supply. Administering morphine (C) is contraindicated as it can depress respiratory function further. Administering fluids (D) is not the priority in managing an obstructed airway.

Question 2 of 5

What is the most important action when caring for a client on intravenous heparin?

Correct Answer: A

Rationale: The correct answer is A: Monitor aPTT levels. This is crucial in intravenous heparin therapy to ensure the therapeutic range is maintained for anticoagulation without causing bleeding. Monitoring aPTT helps adjust heparin dosage to prevent clot formation or excessive bleeding. B: Monitoring for bleeding is important but not the most important action compared to monitoring aPTT levels for appropriate dosing. C: Checking platelet count is important for some anticoagulants like heparin, but aPTT monitoring is more directly related to heparin's anticoagulant effect. D: Administering a heparin antidote (protamine sulfate) is necessary in case of heparin overdose or in emergency situations but is not the primary action in routine care.

Question 3 of 5

What should be the nurse's first intervention for a client with acute abdominal pain?

Correct Answer: A

Rationale: The correct answer is A: Assess vital signs. This is the first intervention because it provides immediate information on the client's condition and helps determine the severity of the pain. Monitoring vital signs can reveal signs of shock, dehydration, or other serious complications. Performing a CT scan (B) is not the first priority as it requires time and resources. Monitoring urine output (C) may be important but not as immediate as assessing vital signs. Monitoring for signs of shock (D) can be included in assessing vital signs but is not the primary intervention.

Question 4 of 5

What is the first intervention for a client with an acute asthma attack?

Correct Answer: A

Rationale: The correct answer is A: Administer bronchodilators. In an acute asthma attack, the priority is to open the airways and improve breathing. Bronchodilators work quickly to relax the muscles around the airways, allowing the client to breathe easier. Corticosteroids are used for long-term control, not immediate relief. Oxygen therapy may be needed if the client's oxygen levels are low. Pain medication is not indicated for an acute asthma attack as the primary issue is airway constriction, not pain. Administering bronchodilators first helps address the immediate breathing difficulty in an asthma attack.

Question 5 of 5

What is the first priority for a client who has developed signs of shock?

Correct Answer: A

Rationale: The correct answer is A: Administer IV fluids. In the case of shock, the first priority is to restore circulating volume to improve tissue perfusion. IV fluids help increase blood volume and improve oxygen delivery to vital organs, addressing the underlying cause of shock. Choice B (Administer oxygen) can be important but is not the first priority. Choice C (Place the client in a supine position) may worsen certain types of shock. Choice D (Monitor blood pressure) is important but not the first action needed to address shock. Administering IV fluids promptly can stabilize the client's condition and prevent further deterioration.

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