A nurse is assessing a client who is 48 hours postoperative following abdominal surgery. Which of the following findings should the nurse report to the provider?
Respiratory rate 18/min.
Blood pressure 102/66 mm Hg.
Yellow-green drainage on the surgical incision.
Straw-colored urine from an indwelling urinary catheter.
The Correct Answer is C
Choice A rationale
A respiratory rate of 18/min is within the normal range for adults and does not typically require immediate intervention.
Choice B rationale
A blood pressure of 102/66 mm Hg is within the normal range for adults and does not typically require immediate intervention.
Choice C rationale
Yellow-green drainage from a surgical incision suggests infection and should be reported to the provider immediately for further evaluation and management.
Choice D rationale
Straw-colored urine from an indwelling urinary catheter is a normal finding and indicates adequate hydration and kidney function
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
According to the Rule of Nines, the percentage of body surface area for different parts of the body is calculated to estimate burn severity. For example, the anterior and posterior aspects of each leg account for 18% each, and the back accounts for 18%. Therefore, the total body surface area burned can be estimated based on these percentages.
Correct Answer is C
Explanation
Choice A rationale
Vitamin B supplements are not sufficient for treating pernicious anemia, as the condition involves an inability to absorb vitamin B12 from the gastrointestinal tract.
Choice B rationale
Iron supplements are not the primary treatment for pernicious anemia, which is specifically caused by a deficiency in vitamin B1289.
Choice C rationale
Vitamin B12 injections are the correct treatment for pernicious anemia. These injections bypass the gastrointestinal tract and provide the necessary vitamin B12 directly into the bloodstream.
Choice D rationale
Blood transfusions are not typically required for the treatment of pernicious anemia unless there is severe anemia or other complications.
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