A nurse is caring for a client who is 3 hr postoperative following abdominal surgery.
Which of the following assessment data should the nurse report to the provider?
Serosanguineous drainage noted on the abdominal dressing.
Postoperative laboratory results are Hgb 15% and Hct 40%.
The client's urine output has been 50 mL since surgery.
The client's pain level has decreased since the administration of morphine.
The Correct Answer is C
Choice A rationale:
Serosanguineous drainage noted on the abdominal dressing is a common finding in the early postoperative period. It is a mixture of clear and bloody drainage and is often seen after surgery. This does not typically require immediate reporting unless it becomes excessive or changes significantly. The nurse can continue to monitor and assess the situation.
Choice B rationale:
Postoperative laboratory results of Hgb 15% and Hct 40% are within the normal range for most adults, and there is no immediate need to report these results to the provider. These values suggest that the client's hemoglobin and hematocrit levels are within an acceptable range, indicating adequate oxygen-carrying capacity.
Choice C rationale:
The client's urine output has been 50 mL since surgery, which is significantly decreased and could indicate a potential issue with renal function or fluid balance. This should be reported to the provider, as it may be indicative of kidney impairment, dehydration, or other postoperative complications.
Choice D rationale:
The client's pain level decreasing after the administration of morphine is an expected response to pain management interventions. There is no need to report this information to the provider unless the pain relief is inadequate or the client experiences adverse effects. Pain management is an essential part of postoperative care, and successful pain reduction is a positive outcome.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Justice is the ethical principle related to fairness and equality in healthcare. It is not applicable in this scenario as it does not address the nurse's action of returning at 1400 for wound care.
Choice B rationale:
Autonomy is the principle that respects a patient's right to make decisions about their own healthcare. While important, this is not the focus of the nurse's action in this scenario.
Choice C rationale:
Veracity refers to truthfulness and honesty in healthcare. The nurse returning at the agreed time of 1400 does not primarily relate to veracity. It is more about keeping a commitment.
Choice D rationale:
Fidelity, or faithfulness, is the ethical principle that the nurse is demonstrating in this scenario. The nurse is keeping their commitment to provide wound care at the agreed time of 1400. This aligns with the principle of fidelity.
Correct Answer is A
Explanation
Choice B rationale:
The statement "The ACA is primarily for individuals requiring tertiary care" is not accurate. The Affordable Care Act (ACA) is designed to improve access to healthcare for a broad range of individuals, not just those in need of tertiary care. It aims to make healthcare coverage more affordable and accessible for all, regardless of the level of care needed.
Choice C rationale:
The statement "Individuals must qualify to participate in ACA insurance coverage" is correct to some extent. Individuals must meet certain eligibility criteria to enroll in ACA insurance plans, such as being a U.S. citizen or lawfully present, but it does not capture the full scope of the ACA's purpose. The primary goal of the ACA is to expand access to healthcare and reduce disparities, not just limited to qualification requirements.
Choice D rationale:
The statement "Individuals with pre-existing conditions are not eligible for ACA coverage" is incorrect. One of the significant achievements of the ACA is that it prohibits insurance companies from denying coverage to individuals with pre-existing conditions. In fact, the ACA has provisions to protect individuals with pre-existing conditions and ensure their access to insurance coverage.
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