A nurse supervisor receives notification of a disaster in the community and the possibility for multiple admissions to the facility. Which of the following clients should the nurse recommend for discharge?
A client who is experiencing an exacerbation of COPD and has been BiPap at night.
A client who is 1 day postoperative following a laparoscopic cholecystectomy and has a temperature of 37.7° C (99.9° F).
A client who reports intermittent chest pain and has received nitroglycerin four times in the past 8 hr.
A client who is receiving a continuous insulin infusion of 5 units/hr following an episode of DKA 2 hr ago.
The Correct Answer is B
Choice A reason: A client with COPD requiring BiPap at night is unstable and at risk for respiratory failure. Discharging them would be unsafe.
Choice B reason: A client who is 1 day postoperative after a laparoscopic cholecystectomy with a low-grade temperature is stable. They can safely continue recovery at home with outpatient follow-up. This makes them the best candidate for discharge.
Choice C reason: A client with intermittent chest pain requiring multiple doses of nitroglycerin is unstable and at risk for myocardial infarction. They require close monitoring and cannot be discharged.
Choice D reason: A client on continuous insulin infusion for recent DKA is unstable and requires ongoing inpatient care. Discharging them would be unsafe.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Prolonged uterine contractions lasting 90 seconds indicate uterine tachysystole, a dangerous adverse effect of oxytocin. This can reduce placental perfusion, compromise fetal oxygenation, and increase risk of uterine rupture. Immediate intervention is required.
Choice B reason: Moderate variability of the fetal heart rate is a reassuring sign of adequate oxygenation and intact neurological function. It is not an adverse effect.
Choice C reason: Contractions every 2 minutes are within the normal therapeutic range for oxytocin augmentation. This frequency supports labor progression without compromising fetal well-being.
Choice D reason: A fetal heart rate of 150/min is within the normal baseline range (110–160/min). This is not an adverse effect.
Correct Answer is A
Explanation
Choice A reason: Melanoma is characterized by asymmetry, irregular borders, and variegated coloring (multiple shades of brown, black, red, or even white). These features are part of the "ABCDE" criteria used to identify suspicious lesions: Asymmetry, Border irregularity, Color variation, Diameter greater than 6 mm, and Evolving changes. This makes option A the correct answer because it describes the hallmark features of melanoma.
Choice B reason: A central crater with rolled borders is more typical of basal cell carcinoma, not melanoma. Basal cell carcinoma often presents as a pearly or waxy nodule with a central depression or ulceration and rolled edges. This option is incorrect because it describes a different type of skin cancer.
Choice C reason: A wart-like texture is commonly associated with squamous cell carcinoma, which can appear as rough, scaly patches or wart-like growths. This is not characteristic of melanoma, which tends to be pigmented and irregular rather than wart-like. Therefore, this option is incorrect.
Choice D reason: A firm and rubbery texture is more typical of benign dermatofibromas or other non-melanoma lesions. Melanomas are usually irregular, pigmented, and may be raised, but they are not typically described as firm and rubbery. This option is incorrect because it does not match the clinical presentation of melanoma.
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