A nurse is caring for an adolescent who is 1 hr postoperative following an appendectomy.
Which of the following findings should the nurse report to the provider?
Muscle rigidity.
Abdominal pain.
Temperature 36.4° C (97.5° F).
Heart rate 63/min.
The Correct Answer is A
Muscle rigidity following an appendectomy could be a sign of a serious complication such as peritonitis and should be reported to the provider immediately.
Choice B is wrong because abdominal pain is a common occurrence following an appendectomy and may not necessarily require immediate attention from the provider.
Choice C is wrong because a temperature of 36.4° C (97.5° F) is within the normal range.
Choice D is wrong because a heart rate of 63/min is within the normal range for an adolescent.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The nurse should prepare the toddler for nasotracheal intubation first because the toddler is experiencing severe dyspnea and drooling, which are signs of airway obstruction.
Nasotracheal intubation will help to secure the toddler’s airway and improve their breathing.
Choice A is wrong because administering an antibiotic is not the priority intervention for a toddler with airway obstruction.
Choice B is wrong because obtaining a blood culture is not the priority intervention for a toddler with airway obstruction.
Choice C is wrong because inserting an IV catheter is not the priority intervention for a toddler with airway obstruction.
Correct Answer is A
Explanation
The nurse should request verbal consent from the client for STI testing.
All 50 states and the District of Columbia explicitly allow minors to consent for their own STI services.
Choice B is wrong because it is not necessary to contact the client’s parents to obtain phone consent.
Choice C is wrong because it is not necessary to postpone the testing until the client’s parents are present.
Choice D is wrong because written consent is not required for STI testing.
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