A one-day post-operative client complains of severe abdominal pain and has shallow respirations at 22/minute. The client is reluctant to perform coughing and deep breathing. Based on the data, the priority problem that the nurse could assign to this patient is:
ineffective gas exchange.
ineffective breathing pattern
activity intolerance.
decreased cardiac function
The Correct Answer is B
Choice A rationale: Ineffective gas exchange is related to respiratory issues but may not be the priority in this case.
Choice B rationale: Ineffective breathing pattern is the priority problem, as evidenced by shallow respirations and reluctance to perform coughing and deep breathing, which can lead to respiratory complications.
Choice C rationale: Activity intolerance is not the priority problem based on the given data.
Choice D rationale: Decreased cardiac function is not the priority problem based on the given data.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
Choice A rationale: Acetaminophen 500 mg PO is subject to the first pass effect as it is absorbed through the gastrointestinal system.
Choice B rationale: Dulcolax suppository is not subject to the first pass effect as it is administered rectally.
Choice C rationale: Aspirin 10 mg PO is subject to the first pass effect as it is absorbed through the gastrointestinal system.
Choice D rationale: Fentanyl 25 mcg/h via transdermal patch avoids the first pass effect as it is absorbed through the skin.
Choice E rationale: Morphine 0.4 mg IV avoids the first pass effect as it is administered intravenously.
Correct Answer is B
Explanation
Choice A rationale: Ineffective gas exchange is related to respiratory issues but may not be the priority in this case.
Choice B rationale: Ineffective breathing pattern is the priority problem, as evidenced by shallow respirations and reluctance to perform coughing and deep breathing, which can lead to respiratory complications.
Choice C rationale: Activity intolerance is not the priority problem based on the given data.
Choice D rationale: Decreased cardiac function is not the priority problem based on the given data.
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