A nurse is caring for a client who develops a pulmonary embolism. Which of the following interventions is the priority for the nurse to take?
Begin oxygen therapy.
Start an IV infusion of lactated Ringer’s.
Initiate cardiac monitoring.
Administer IV morphine.
The Correct Answer is A
a. Begin oxygen therapy: Oxygen therapy is the priority intervention for a client with a pulmonary embolism to improve oxygenation and prevent hypoxemia.
b. Start an IV infusion of lactated Ringer’s: While fluid resuscitation may be needed, oxygen therapy takes precedence to address the immediate respiratory compromise.
c. Initiate cardiac monitoring: Cardiac monitoring is important, but addressing oxygenation is the priority in a client with a pulmonary embolism.
d. Administer IV morphine: Pain management may be necessary, but the priority is to address the respiratory distress and potential hypoxemia associated with a pulmonary embolism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
a. Tetany: A calcium level of 8 mg/dl is low and can be associated with tetany.
b. Constipation:This is associated with hypercalcemia as opposed to hypocalcemia
c. Negative Chvostek sign: A positive Chvostek sign is associated with hypocalcemia, not hypercalcemia.
d. Elevated blood pressure: Elevated calcium levels are not typically associated with elevated blood pressure. Hypertension is not a common manifestation of hypercalcemia.
Correct Answer is D
Explanation
a. "The pain radiates down to my lower back." This statement is not typical of peptic ulcer
disease. Radiation of pain to the lower back may suggest other abdominal or musculoskeletal issues.
b. "I feel so much better after eating." Relief of pain after eating is more indicative of gastric ulcer rather than peptic ulcer disease. Peptic ulcers are often associated with pain that worsens after eating.
c. "My pain is relieved by having a bowel movement." Relief of pain with bowel movements is
not a characteristic finding of peptic ulcer disease. This may suggest other gastrointestinal issues.
d. "The pain is worse after I eat a meal high in fat." This statement is consistent with peptic ulcer disease. High-fat meals stimulate gastric acid secretion, potentially exacerbating the pain
associated with peptic ulcers.
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