A nurse is caring for a client.
A nurse is reviewing the client's medical record. After reviewing the medical record, which of the following actions should the nurse plan to take? For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.
Potential Prescription: Anticipated /Nonessential /Contraindicated
Encourage the client to cough.
Keep the client's head in a midline position.
Elevate the head of the bed.
Assist the client to the bathroom.
Initiate seizure precautions.
Decrease oxygen to 1.5 L/min via nasal cannula.
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"C"},"E":{"answers":"A"},"F":{"answers":"C"}}
A) Coughing is not directly related to the client's condition as described in the scenario.
B) Keeping the client's head in a midline position is anticipated to maintain an open airway and prevent further complications, particularly after a cerebrovascular accident.
C) Elevating the head of the bed is anticipated as it can help improve respiratory function and reduce intracranial pressure, which is beneficial given the client's history of cerebrovascular accident and current restlessness and agitation.
D) Assisting the client to the bathroom is contraindicated due to the client's current unresponsiveness and risk of falls; a bedpan or catheter may be more appropriate.
E) Initiating seizure precautions is anticipated because the client's Glasgow Coma Scale score indicates a decreased level of consciousness, which could predispose them to seizures, especially with a history of cerebrovascular accident.
F) Decreasing oxygen to 1.5 L/min via nasal cannula is contraindicated given the client's decreased oxygen saturation levels; instead, the nurse should anticipate the need to maintain or increase oxygen to ensure adequate tissue perfusion.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Syphilis is a bacterial infection, so antiviral medication is not appropriate.
Treatment typically involves antibiotics, such as penicillin.
B. Cryotherapy is not a standard treatment for primary syphilis. Antibiotics are the primary treatment.
C. This is in line with the treatment guidelines for syphilis, which involve antibiotic therapy and follow-up testing to ensure the infection is fully resolved. The tests are done at 3, 6, and 12 months after completion of treatment.
D. Monitoring after medication doses may be necessary for certain medications but is not specifically indicated for primary syphilis.
Correct Answer is A
Explanation
A) Decreasing protein intake is often recommended for clients with nephrotic syndrome to reduce proteinuria and slow the progression of kidney damage.
B) Decreasing carbohydrate intake is not typically a focus of dietary recommendations for nephrotic syndrome.
C) Increasing potassium intake may not be appropriate, as clients with nephrotic syndrome may be at risk of hyperkalemia due to impaired kidney function.
D) Increasing phosphorus intake is not typically indicated and may exacerbate complications associated with kidney dysfunction in nephrotic syndrome.
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