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 B
Explanation
Chest physiotherapy treatments aim to improve ventilation and mucociliary clearance by removing tenacious and obstructing secretions in patients with cystic fibrosis.
Increased expectoration indicates that the therapy has been effective in clearing secretions.
Choice A is wrong because increased urine output is not an indication of the effectiveness of chest physiotherapy.
Choice C is wrong because reduced pain is not a specific indication of the effectiveness of chest physiotherapy.
Choice D is wrong because increased heart rate is not an indication of the effectiveness of chest physiotherapy.
Correct Answer is A
Explanation
Following the child’s home sleep routine can help reduce anxiety and promote adequate sleep.
Children thrive on routine and consistency, and maintaining their usual sleep routine can provide a sense of familiarity and comfort in an unfamiliar environment.
Choice B is wrong because leaving the lights on can disrupt the child’s sleep.
Choice C is wrong because allowing the child to adjust their bedtime may disrupt their sleep routine and lead to inadequate sleep.
Choice D is a good option, but following the child’s home sleep routine is the best way to promote adequate sleep.
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