1) Which one of the following statements about abuse is true?
A) It is typically found in those who have lower incomes.
B) It tends to occur more often to those with mental health problems.
C) It most often occurs to those who are unable to report it.
D) It is found in all socioeconomic levels.
2) A 49-year-old male has summoned EMS because of a problem with his tracheostomy tube. At the patient’s side, you note the tracheostomy tube to be protruding abnormally from the stoma in his neck. Your first action in caring for this patient would be to:
A) gently attempt to reinsert the tracheostomy tube.
B) quickly establish a baseline SpO2 level.
C) establish how the tracheostomy tube became dislodged.
D) evaluate the patient’s airway and breathing.
3) When assessing a 32-year-old male with a history of mental retardation, you note the protrusion of a clamped tube from her back in the area of her right kidney. The best method of determining what the tube is and why it is in place would be to:
A) contact medical direction.
B) ask family members.
C) contact the home health nursing agency.
D) ask the patient.
4) Which one of the following best describes an oxygen concentrator?
A) Portable oxygen device that extracts oxygen from the air
B) Nasal cannula connected to a small cylinder of oxygen
C) Small portable device that administers high-concentration oxygen
D) Small oxygen tank that holds concentrated liquid oxygen
5) You have been called to a residence for a 63-year-old female with a history of COPD who is short of breath. The patient is moderately dyspneic with the following vital signs: pulse 124, respirations 20, blood pressure 162/56, and SpO2 at 86%. She is using an oxygen concentrator set at 5 lpm. What is your best course of action?
A) Attach a nonrebreather to the oxygen concentrator and increase the liter flow to 12.
B) Continue oxygen administration with the concentrator and transport the patient.
C) Remove the oxygen concentrator and administer high-concentration oxygen to the patient.
D) Administer medical oxygen from your cylinder at the same rate as the concentrator.
6) You are by the side of a 2-month-old baby who was born prematurely and is on an apnea monitor. While in your care, the apnea alarm emits a loud alarm. Quick assessment of the baby reveals no respiratory activity. Your immediate action would be to:
A) Place the baby on the cot and transport.
B) Start positive pressure ventilation.
C) Administer high-concentration oxygen.
D) Check the apnea monitor.
7) Family has called you after the apnea alarm for their 1-month-old baby sounded. They state that the settings seem too high and the alarm goes off frequently. They would like the home health nurse to readjust the settings, so this scenario can be avoided in the future. They do not want the patient transported to the hospital and are prepared to sign a refusal. Assessment reveals no life threats to the airway, breathing, or circulation. Given the situation, you would:
A) have a refusal witnessed and signed.
B) adjust the monitor settings and have a refusal signed.
C) contact medical direction.
D) contact the home health nurse.
8) The wife of a patient, with terminal lung cancer and a Do Not Resuscitate (DNR) order, has called 911 because her husband’s pulse oximeter reading fell below 85% and alarmed. He is currently receiving home oxygen through a nasal cannula. Assessment reveals him to be alert and oriented and slightly tachypneic with no abnormal lung sounds. At this time, your next action would be to:
A) start positive pressure ventilation.
B) check the SpO2 using your pulse oximeter.
C) administer oxygen through a new nasal cannula.
D) place him on the stretcher for transport to the hospital.
9) When assessing a 65-year-old male patient, you note a tube-like device inserted into the lower portion of his trachea. You recognize that the device has most likely been placed to:
A) to permit the exchange of O2 and CO2.
B) to allow the patient to be fed a liquid diet.
C) to allow the patient to talk.
D) to allow easy suctioning of the lower airway.
10) When suctioning a 46-year-old male with a tracheostomy tube, which of the following is appropriate?
A) Suction from above, using the mouth or nose.
B) Suction no more than 5 seconds using a hard-tipped suction.
C) Introduce 20 mL of sterile water into the tracheostomy tube prior to suctioning.
D) Insert the suction cannula until resistance is met.
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