A young adult client has a partner and no children. The client has a hysterectomy because of endometrial cancer. The client has an IV and an indwelling urinary catheter. The client is crying asking for their partner. Which action does the nurse take first?

Assesses the IV site for inﬂammation

Measures the urine output for the day

Calls the partner to come and visit

Asks the client if pain medication is required

Answer and Explanation

The Correct Answer is C

The client is likely feeling scared, vulnerable, and alone. By calling the partner to come and visit, the nurse can provide the client with emotional support and comfort during this difficult time. This can also help to alleviate the client's distress and promote a sense of security and familiarity.

Assessing the IV site for inﬂammation (a) and measuring the urine output for the day (b) are important aspects of the client's care, but they are not the priority in this situation. Asking the client if pain medication is required (d) is also important, but it can wait until the client's emotional needs have been addressed.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

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

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is ["A","C","F"]

Explanation

An increase in blood pressure (BP) from 112/68 mm Hg to 122/80 mm Hg indicates an improvement in hemodynamic status, as it shows that the client's blood vessels are constricting to maintain BP and tissue perfusion. f) An increase in urine output from 18 mL/hour to 45 mL/hour indicates an improvement in renal function and ﬂuid balance, which is important for maintaining hemodynamic stability. c) An increase in serum potassium level from 5 mEq/L (5 mmol/L) to 5.4 mEq/L (5.4 mmol/L) indicates an improvement in electrolyte balance, which is important for maintaining proper cardiac function and hemodynamic stability.

Option b) Serum sodium decreased from 146 mEq/L (146 mmol/L) to 138 mEq/L (138 mmol/L) is not a finding that indicates improvement in hemodynamic status. Hyponatremia or low serum sodium levels can cause ﬂuid shifts in the body leading to altered mental status, seizures, and cerebral edema, among other complications. However, the given information does not suggest that the client has hyponatremia or that their hyponatremia has improved.

Option d) Urine output averaging 18 mL/hour is not an improvement, and it may indicate renal insufficiency or failure, which can lead to ﬂuid overload and hemodynamic instability.

Option e) Bowel sounds in all four quadrants indicate normal bowel motility, which is important for proper digestion and absorption of nutrients but does not directly indicate an improvement in hemodynamic status.

A. Wear sterile gloves to pack the wound. B. Clean the skin around the wound with non-sterile 4x4 gauze. C. Don an eye shield before irrigating the wound. D. Use alcohol-based hand sanitizer between glove changes. E. Pour sterile normal saline into a sterile irrigation tray. F. Obtain a wound culture before the wound bed is irrigated. G. Cover the irrigated packing with an ABD pad. H. Assess pain prior to starting the procedure. I. Wear sterile gloves to remove the old dressing.

Correct Answer is ["A","C","E","F","G","I"]

Explanation

a) It is important to wear sterile gloves when packing the wound to prevent the introduction of new bacteria into the wound.
c) Donning an eye shield protects the nurse from splash-back or aerosolized particles during irrigation.
e) Sterile normal saline should be used for irrigation to prevent introducing new bacteria to the wound. It should be poured into a sterile irrigation tray.
f) A wound culture should be obtained before the wound bed is irrigated to prevent diluting the specimen with irrigation solution.
g) After irrigating the wound and packing it with sterile gauze, the packing should be covered with an ABD pad to protect the wound and prevent contamination.
h) Assessing pain prior to starting the procedure is important to establish a baseline for pain management and to monitor the client's response to the procedure.
i) Sterile gloves should be worn when removing the old dressing to prevent introducing new bacteria to the wound.
b) Cleaning the skin around the wound with non-sterile gauze is not appropriate as it can introduce new bacteria to the wound.
d) Alcohol-based hand sanitizer is not a substitute for hand washing and should not be used between glove changes as it does not eﬀectively remove all bacteria from the hands.

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 young adult client has a partner and no children. The client has a hysterectomy because of endometrial cancer. The client has an IV and an indwelling urinary catheter. The client is crying asking for their partner. Which action does the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","C","F"]

Explanation

Correct Answer is ["A","C","E","F","G","I"]

Explanation

The nurse provides care for a child with an abdominal wound. The wound edges are approximated. Which does the nurse include when rendering the prescribed wound care to this child? (Select all that apply)

The nurse provides care for a client recovering from a motor vehicle crash. For which sign of ﬂuid volume overload does the nurse measure the client's intake and output? (Select all that apply)

The nurse delegated vital signs for a group of patients to the unlicensed assistive personnel (UAP). Which client condition would prohibit having a rectal temperature taken by the UAP?

The nurse provides care for a client with a poor appetite. Which action does the nurse take to enhance the client's nutritional intake?

An infant client has a tracheostomy. The nurse prepares to suction the tracheostomy. Which most important principle does the nurse use to plan care?

The nurse omits to document an assessment finding that resulted in a significant client injury. For which legal issue does the nurse need to prepare?

The nurse instructs the client on the use of an incentive spirometer. Which observation indicates to the nurse that additional teaching is required?

The nurse provides care for a patient with an infected surgical wound. The nurse assesses the wound and changes the dressing. Which does the nurse include in the documentation? Select all that apply.