A home health nurse is seeing an elderly male client for the first time. During the physical assessment of the skin on the lower legs the skin is pale and cool to touch. The nurse notes small circular ulcers on the soles of his feet. From these findings, the nurse knows that the client has a problem with circulation. Which of the circulation condition does the nurse suspect?

Necrotic wound

Trauma

Venous insufficiency

Arterial insufficiency

Answer and Explanation

The Correct Answer is D

The findings of pale and cool skin on the lower legs, along with small circular ulcers on the soles of the feet, are indicative of arterial insufficiency. Arterial insufficiency occurs when there is a decreased blood flow to the extremities, often due to conditions such as atherosclerosis or peripheral arterial disease. This reduced blood flow can result in pale and cool skin, as well as the development of ulcers, which are typically round and have well-defined borders. It is essential to assess and manage arterial insufficiency promptly to prevent complications like tissue necrosis and gangrene.

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Correct Answer is ["165"]

Explanation

To calculate the low range of the dosage, we need to use the lower end of the dosage range provided (1.5 mg/kg) and the client's weight in kilograms.

1 lb is approximately equal to 0.45 kg. So, to convert the client's weight from pounds to kilograms:

245 lbs * 0.45 kg/lb = 110.25 kg

Now, to calculate the low range dosage:

Low range dosage = 1.5 mg/kg * 110.25 kg = 165.375 mg

Rounding to the nearest whole number, the nurse should administer 165 mg for the low range of the dosage.

A. Urinary tract infection B. Acute kidney failure C. Septic shock D. Urinary stasis

Correct Answer is A

Explanation

A. Urinary tract infection
The symptoms described, including recent mental status changes and periods of incontinence, are suggestive of a urinary tract infection (UTI) in an elderly individual. UTIs are common among older adults and can cause a variety of symptoms, including confusion, which is often the primary manifestation in the elderly population. Other symptoms can include urinary urgency, frequency, and incontinence.

B. Acute kidney failure - While acute kidney failure can cause changes in urination and mental status, it is less likely to be the primary cause of these symptoms in this scenario. UTI is a more common and immediate concern given the symptoms described.

C. Septic shock - Septic shock is a severe condition that occurs when an infection leads to a life-threatening drop in blood pressure. While septic shock can cause altered mental status, it is a critical condition that often presents with more dramatic symptoms and requires immediate intensive care management. The symptoms described are more suggestive of a UTI.

D. Urinary stasis - Urinary stasis refers to the slowing or cessation of urine flow. While urinary stasis can contribute to the development of UTIs, it is not a condition that would cause sudden and acute mental status changes and incontinence on its own. UTI is a more likely cause of the symptoms described.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a pulmonary embolism and has a new prescription for enoxaparin 1.5-2.5mg/kg subcutaneous. The client weighs 245 lbs. How many mg should the nurse administer for the low range of the dosage range? (Round the answer to the nearest whole number.)

Correct Answer is ["165"]

Explanation

The nurse is caring for an 84-year-old female client who was brought to the emergency room by her daughter, who related that her mother has had very recent mental status changes and periods of incontinence. What condition should the nurse first suspect?

Correct Answer is A

Explanation

A nurse is caring for a client who has multiple long bone fractures caused by a motor-vehicle crash that happened 24 hr ago. The client tells the nurse he is short of breath and experiencing chest pain. The nurse should assess the client further for which of the following potential complications?

A nurse is teaching an older adult client who has osteoporosis about beginning a program of regular physical activity. Which of the following recommendations should the nurse make?

A nurse is completing a risk assessment on a new admission. Which standardized scale will the nurse use to calculate the client's risk for pressure ulcers?

A nurse is caring for an older adult client who is at risk for skin breakdown. Which of the following interventions should the nurse use to help maintain the integrity of the client's skin?

The nurse understands that certain patients are more susceptible to pressure ulcer development. Which clients should the nurse identify as being at an increased risk for this health problem? Select all that apply.

A nurse is to administer a 500ml bolus of normal saline to a patient over 1 hour?

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