A nurse is caring for a neonate in the neonatal intensive care unit.

Exhibits

The nurse is reviewing the neonate's electronic medical record.

Drag words from the choices below to fill in each blank in the following sentence.

Following discontinuation of feedings, the nurse should monitor for

and

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Sepsis: Preterm neonates are at increased risk for infections, including sepsis. Discontinuation of feedings, along with the other signs observed (such as abdominal distention, blood in stool, lethargy, and hypotonia), may suggest the onset of infection, which requires close monitoring.

Hypotension: Preterm neonates are also at risk for hypotension due to immature circulatory systems. The stress of gastrointestinal disturbances, such as abdominal distention and the potential for necrotizing enterocolitis (NEC), can result in decreased perfusion, contributing to hypotension.

Nursing Test Bank

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

Explanation

Hypostatic pneumonia: The client's immobility due to paraplegia increases the risk of fluid accumulation in the lungs, leading to infection.
Immobility: Prolonged immobility is a significant risk factor for hypostatic pneumonia, as it impairs normal lung drainage and promotes bacterial growth

A. Hypotension B. Tachycardia C. Dyspnea D. Dry cough

Correct Answer is C

Explanation

A. Hypotension is a concern but may occur for various reasons and is not as immediately life-threatening as dyspnea.

B. Tachycardia can indicate a problem but is less urgent than respiratory distress.

C. Dyspnea is the priority as it may indicate a recurrence of pulmonary embolism or another life-threatening respiratory issue.

D. A dry cough is a less urgent symptom and does not require immediate reporting.

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Body Systems	Findings
Respiratory	Respiratory rate 26/min
Cardiovascular	Heart rate 112/min Capillary refill 4 seconds
Gastrointestinal	Hyperactive bowel sounds
Integumentary	Diaper area reddened with erythema noted Extremities cool Reports no tears
Neurologic	Lethargic

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client in an acute care setting. Exhibits Complete the following sentence by using the list of options. The client is at risk for _________ as evidenced by _______.

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

Explanation

A nurse is assessing a client who is postoperative and has a history of pulmonary embolism. Which of the following findings is the priority for the nurse to report to the provider?

Correct Answer is C

Explanation

A nurse is creating a plan of care for a client who has paranoid personality disorder and refuses to take their medication. Which of the following interventions should the nurse include in the plan?

A nurse is preparing a client for transfer to a long-term rehabilitation facility following a below-knee amputation of the right leg. Which of the following actions should the nurse take to protect the client's confidentiality?

A nurse is caring for a client who has pneumonia and tells the nurse, "I feel like an elephant is sitting on my chest." The client is weak and unable to walk. After the nurse initiates chest pain protocol, which of the following is the priority diagnostic test?

A nurse is caring for a male client who has a spinal cord injury. Which of the following techniques should the nurse use when providing perineal care?

A nurse is caring for a client who has heart failure. Which of the following manifestations should the nurse expect?

A nurse manager is addressing reports of conflict within a nursing unit. The nurse should identify which of the following situations as an example of interpersonal conflict?

A nurse is caring for a newborn. Exhibits SELECT words from the choices below to fill in each blank in the following sentence. The client is at risk for developing ________ and ___________