A nurse is assisting in the care of a client who is receiving newly prescribed IV antibiotics. Which of the following findings should the nurse report immediately?

Small, raised vesicles over the body

Rhinitis

Itching of the skin

Severe wheezing

Answer and Explanation

The Correct Answer is D

Rationale:

A. Small, raised vesicles over the body may indicate an allergic reaction but are not typically associated with IV antibiotics.

B. Rhinitis may indicate an allergic reaction but is not typically associated with IV antibiotics.

C. Itching of the skin may indicate an allergic reaction but is not typically associated with IV antibiotics.

D. Severe wheezing may indicate an allergic reaction or anaphylaxis and should be reported immediately.

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Correct Answer is B

Explanation

Rationale:

A. Using the incentive spirometer is important for preventing atelectasis, but it does not prevent orthostatic hypotension.

B. Dangling the legs over the side of the bed before standing helps reduce the risk of orthostatic hypotension by allowing the body to gradually adjust to the change in position.

C. Increasing protein intake is important for wound healing and tissue repair, but it does not prevent orthostatic hypotension.

D. Performing regular isometric exercises is important for maintaining muscle strength and mobility, but it does not prevent orthostatic hypotension.

A. Unlock and remove the inner cannula. B. Scrub the inside and outside of the inner cannula with a small brush C. Wipe the inside of the inner cannula with a folded pipe cleaner. D. Pour 2.54 cm (1 in) of 0.9% sodium chloride solution into the sterile basin. E. Cleanse the stoma site with 0.9% sodium chloride solution.

Correct Answer is A,D,B,C,E

Explanation

A. Unlock and remove the inner cannula is the first step because it allows access to the inner cannula for cleaning.
B. Scrub the inside and outside of the inner cannula with a small brush is the third step because it removes debris and secretions from the inner cannula.
C. Wipe the inside of the inner cannula with a folded pipe cleaner is the fourth step because it further cleans the inner cannula.
D. Pour 2.54 cm (1 in) of 0.9% sodium chloride solution into the sterile basin is the second step because it provides the solution for cleaning the inner cannula.

E. Cleanse the stoma site with 0.9% sodium chloride solution is the final step because it cleans the stoma site before replacing the inner cannula.

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A nurse is assisting in the care of a client who is receiving newly prescribed IV antibiotics. Which of the following findings should the nurse report immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Correct Answer is A,D,B,C,E

Explanation

Nurses' Notes

Company

Resources

A nurse is assisting in the care of a client who is receiving newly prescribed IV antibiotics. Which of the following findings should the nurse report immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is postoperative and is preparing to walk for the first time in several days. Which of the following instructions should the nurse give the client to prevent orthostatic hypotension?

Correct Answer is B

Explanation

A nurse is preparing to provide tracheostomy care to a client who has a chronic tracheostomy. In which order should the nurse complete the following steps? (Move the steps into the box on the right, placing them in the order of performance. Use all the steps.)

Correct Answer is A,D,B,C,E

Explanation

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Nurses' Notes

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