A nurse is caring for a 24-year-old female client who fell while horseback riding in the accident emergency unit.

Exhibits
A nurse is preparing the client for surgery. Based on the provided data, which of the following are the most critical to address before proceeding with the exploratory laparotomy? Select all that apply.

Hemoglobin of 9.3 g/dL

Prothrombin time of 11.5 seconds

Blood pressure of 90/48 mm Hg

Heart rate of 110 beats/minute

Abdominal distention

Answer and Explanation

Correct Answer : A,C,E

Choice A rationale: Hemoglobin of 9.3 g/dL indicates that the client has anemia, likely due to blood loss from the injury. This low hemoglobin level suggests significant bleeding, which needs to be addressed to ensure adequate oxygen delivery to tissues during surgery.

Choice B rationale: Prothrombin time of 11.5 seconds is within the normal range and does not indicate a critical issue that needs to be addressed before surgery. It suggests that the client's blood clotting mechanism is functioning properly.

Choice C rationale: Blood pressure of 90/48 mm Hg indicates hypotension, which is a sign of shock or significant blood loss. It is critical to stabilize the client's blood pressure to ensure adequate perfusion to vital organs during surgery.

Choice D rationale: Heart rate of 110 beats/minute is elevated, which may be a response to pain, anxiety, or hypovolemia. While it is important to monitor, it is not as critical as addressing the hypotension and anemia before surgery.

Choice E rationale: Abdominal distention indicates potential internal bleeding or injury to abdominal organs. This needs to be addressed urgently, as it can lead to further complications and affect the outcome of the surgery.

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Correct Answer is B

Explanation

Choice A rationale

Mixed berries are rich in antioxidants and nutrients, but they do not specifically provide the calcium and vitamin D necessary to support bone health in postmenopausal women, who are at increased risk for osteoporosis.

Choice B rationale

Low-fat yogurt is a good source of calcium and vitamin D, which are vital for maintaining bone density and preventing osteoporosis in postmenopausal women. These nutrients are crucial as estrogen levels drop, increasing the risk of bone loss.

Choice C rationale

Carrots are high in beta-carotene and fiber but do not significantly contribute to calcium and vitamin D intake. While beneficial for overall health, they are not the primary focus for bone health in postmenopausal women.

Choice D rationale

Beets offer various vitamins and minerals but lack substantial amounts of calcium and vitamin D. They are not emphasized for bone health in postmenopausal women, who need to prioritize nutrients that support bone density.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"E"}

Explanation

Epidural anesthesia can cause vasodilation and a resultant drop in blood pressure, hence the importance of close monitoring and IV fluid administration to maintain blood pressure levels.

Risk Factors:

Peripheral vasodilation: This is related to the relaxation of blood vessels, which can lead to a drop in blood pressure (hypotension). It is not a direct risk on its own but a cause of hypotension.
Hypotension: This is the correct answer. Epidural anesthesia can cause a significant drop in blood pressure due to vasodilation.
Urinary retention: This can occur with epidural anesthesia as the sensation to urinate may be diminished, causing the bladder to fill and potentially lead to bladder distention and discomfort.
Fluid overload: This is less commonly associated with epidural anesthesia. It is typically related to excessive intravenous fluid administration.

Causes:

Inadequate pain relief: This would not directly cause the issues mentioned above but would indicate that the epidural is not effectively managing the client's pain.
Decreased fetal heart rate: This can be a consequence of maternal hypotension, which reduces blood flow to the placenta.
Full urinary bladder: This can be a result of urinary retention due to the effects of the epidural, but it is not a direct cause of hypotension.
Inability to push: This can occur with epidural anesthesia as it may decrease the ability to feel contractions and effectively push during delivery, but it is not related to hypotension.

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Naxlex Comprehensive Predictor Exams

The nurse is providing a nutrition class to a group of postmenopausal clients. Which food should the nurse emphasize to this group?

Correct Answer is B

Explanation

Scenario: A nurse is caring for a 26-year-old gravida 2 para 1 female client in the labor and delivery unit. Exhibits The client receiving epidural anesthesia would be at risk for developing dropdown due to dropdown.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"E"}

Explanation

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A nurse is caring for a 24-year-old female client in the emergency department (ED). Exhibits What is the most likely diagnosis for this client, based on the history, physical exam, and diagnostic results?

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