A post-operative patient is at risk for developing a wound infection. Which of the following nursing assessments is the highest priority to prevent this complication?

Monitoring the patient's vital signs

Assessing the patient's pain level

Inspecting the surgical incision site for redness, swelling

Assessing the patient's fluid intake and output

Answer and Explanation

The Correct Answer is C

A.   While important for overall patient assessment, it's not the most direct way to monitor for a wound infection.
B.   Pain can indicate a wound infection, but it's not as specific as directly inspecting the wound.
C.   This is the most direct way to assess for early signs of a wound infection. Redness, swelling, warmth, and drainage are classic signs of infection.
D.   Important for overall patient care, but not specifically related to wound infection prevention.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

A. Changing the patient's head position during suctioning can increase discomfort and hypoxia.
B. This is premature. The tachycardia may be a temporary response to the suctioning procedure.
C. The increased heart rate is likely a response to the stimulation of suctioning. Stopping the procedure allows the patient to recover and reassessment can determine if further suctioning is necessary.
D. This is excessive and not necessary at this time.

A. Tape the connections between the chest tube and drainage tube. B. Loop the tubing of the chest tube on the client's bed. C. Place the chest tube drainage system above the level of the client's heart. D. Perform routine stripping of the client's chest tube every 2 hrs.

Correct Answer is A

Explanation

A. This helps prevent air leaks and maintains the closed drainage system's function.
B. Looping the tubing on the client's is incorrect as it can lead to inaccurate drainage and measurement of the fluid.
C. Placing the drainage system above the level of the client's heart is incorrect as it can lead to inaccurate drainage and measurement of the fluid.
D. Routine stripping of the chest tube is also not recommended as it can cause trauma to the pleura and potentially lead to complications.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A post-operative patient is at risk for developing a wound infection. Which of the following nursing assessments is the highest priority to prevent this complication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is suctioning the endotracheal tube of a client who is on a ventilator. The client's heart rate increases from 86/min to 110/min and becomes irregular. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is caring for a client who has a chest tube. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

A nurse is teaching a client who has a prescription for home oxygen therapy. Which of the following instructions should the nurse include?

A nurse is teaching a class about oxygen transport in the cardiopulmonary system. Which of the following transports oxygen in the blood?

Which of the following is a potential consequence of consuming alcohol prior to an outpatient surgical procedure involving anesthesia?

A nurse is assessing a client who has COPD. Which of the following findings should the nurse expect?

A nurse is planning to administer a unit of PRBCS for a client. Which of the following actions should the nurse plan to take?

A nurse is preparing to administer vancomycin 15 mg/kg/day divided equally every 12 hr. The client weighs 198 lb. How many mg should the nurse administer with each dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)