A nurse is caring for a toddler admitted to the hospital.

Exhibits

Click to highlight the findings that require immediate follow-up. To deselect a finding, click on the finding again.

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

A school nurse is performing scoliosis screenings. The nurse should recognize which of the following clinical manifestations as an indication of scoliosis?

A nurse is assessing the fontanels of an 8-month-old infant. Which of the following findings should the nurse recognize as an expected finding?

A nurse is caring for a 9-year-old child at a clinic.

The nurse should determine that the assessment findings are consistent with which of the following conditions?

For each potential condition, click to specify if the assessment findings are consistent with a sprain, a fracture, or a dislocation. Each finding may support more than 1 condition.

A nurse is preparing to insert an IV catheter for a client. Which of the following actions should the nurse plan to take?

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 client who is 4 days postpartum following a cesarean birth.

For each potential assessment finding, click to specify if the assessment finding is consistent with mastitis or endometritis. Each finding may support more than 1 disease process.

A nurse is caring for a client who is receiving radiation therapy and is experiencing anorexia. Which of the following actions should the nurse take?

A nurse is caring for a neonate in the neonatal intensive care unit. Q122

Which findings in the client's electronic medical record (EMR) are risk factors for the client developing a complication? Select all that apply.

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 neonate in the neonatal intensive care unit.

For each potential intervention, click to specify if the intervention is anticipated or contraindicated for the neonate. There must be at least 1 selection in every row. There does not need to be a selection in n in every column.