A nurse in an emergency department is planning care for a client who has abdominal trauma from a motor-vehicle crash. Which of the following provider prescriptions should the nurse implement first?

Place a large-bore IV catheter in an upper extremity.

Administer packed RBCs.

Obtain a specimen for ABG analysis.

Insert an indwelling urinary catheter.

Answer and Explanation

The Correct Answer is A

A. Place a large-bore IV catheter in an upper extremity: Establishing rapid IV access with a large-bore catheter is the priority in a client with abdominal trauma because it allows for immediate fluid resuscitation and administration of blood products if hemorrhage is present. Prompt vascular access is essential for stabilizing circulation and preventing shock.

B. Administer packed RBCs: Blood transfusion is critical for treating hypovolemia, but it cannot occur until IV access is established. Administering RBCs without a patent, large-bore line is unsafe and impractical in an emergency setting.

C. Obtain a specimen for ABG analysis: While ABG analysis provides valuable information on oxygenation and acid-base status, it is not the immediate priority. Ensuring vascular access and hemodynamic stability takes precedence in acute trauma care.

D. Insert an indwelling urinary catheter: Urinary catheterization is important for monitoring output and assessing renal perfusion, but it is secondary to establishing IV access and stabilizing the client’s circulatory status.

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Correct Answer is A

Explanation

A. Eat a light snack before bedtime: Consuming a small, easily digestible snack, such as a piece of fruit or a glass of milk, can help prevent hunger-related awakenings and promote relaxation, supporting better sleep in older adults.

B. Take a 1-hr nap during the day: Long daytime naps can disrupt the sleep-wake cycle and contribute to difficulty falling asleep at night. Short naps (20–30 minutes) earlier in the day are preferable for older adults.

C. Stay in bed at least 1 hr if unable to fall asleep: Remaining in bed when unable to sleep can reinforce negative associations between the bed and wakefulness, potentially worsening insomnia. Clients should get out of bed and engage in a quiet activity until sleepy.

D. Perform exercises prior to bedtime: Vigorous exercise close to bedtime can increase arousal, heart rate, and body temperature, making it harder to fall asleep. Exercise is best scheduled earlier in the day to promote nighttime sleep.

A. The client is voiding at least 250 mL/hr. B. The client is maintaining bed rest. C. The client is tolerating clear liquids. D. The client is consuming 1,000 calories daily.

Correct Answer is C

Explanation

A. The client is voiding at least 250 mL/hr: Normal urine output for adults is approximately 30 mL/hr. Voiding 250 mL/hr is unusually high and may indicate overhydration or diuresis; this is not an expected postoperative finding.

B. The client is maintaining bed rest: Early ambulation is encouraged after gastric banding to prevent complications such as venous thromboembolism, pneumonia, and delayed bowel function. Prolonged bed rest is not an expected or recommended postoperative behavior.

C. The client is tolerating clear liquids: After gastric banding, clients are typically advanced to clear liquids initially, progressing slowly to full liquids and soft foods as tolerated. Tolerance of clear liquids at 36 hours postoperatively is an expected and appropriate finding.

D. The client is consuming 1,000 calories daily: Postoperative dietary intake is extremely limited immediately following gastric banding. Consuming 1,000 calories per day this early is not typical, as intake usually starts with small, frequent, clear-liquid servings.

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A nurse in an emergency department is planning care for a client who has abdominal trauma from a motor-vehicle crash. Which of the following provider prescriptions should the nurse implement first?

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