Dr. Whitten just evaluated Ms. Sanchez and has written the following orders: Choose which order must be completed first.

Ceftriaxone 1 gm IVPB

Antipyretic given every 6 hours

Blood and sputum cultures

Monitor Blood Glucose before meals and at Bedtime

Monitor I and O

Answer and Explanation

The Correct Answer is C

Choice A reason: Ceftriaxone treats infection, but giving it before cultures risks sterilizing samples, skewing results. It’s critical therapy, yet obtaining accurate diagnostics first ensures targeted treatment, delaying antibiotics briefly.

Choice B reason: Antipyretics reduce fever, a symptom, not the cause. Cultures take priority to identify pathogens before comfort measures, as fever management doesn’t alter diagnostic or treatment urgency in this case.

Choice C reason: Blood and sputum cultures identify the causative organism in suspected infection (e.g., pneumonia). They must be obtained first, before antibiotics, to ensure accuracy, guiding effective therapy and avoiding false negatives.

Choice D reason: Monitoring glucose is routine, not urgent in acute infection unless diabetic crisis is suspected. Cultures precede this, as identifying the pathogen drives treatment, while glucose can wait without immediate risk.

Choice E reason: Monitoring intake and output tracks fluid status, useful but secondary in acute infection. Cultures are the priority to diagnose and treat effectively, as I&O doesn’t alter initial management decisions.

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Correct Answer is D

Explanation

Choice A reason: Vasoconstrictors like oxymetazoline shrink vessels, aiding epistaxis control. It’s a secondary step requiring preparation, not first, as direct pressure is faster, non-invasive, and effective for initial hemostasis in most anterior bleeds.

Choice B reason: Packing with a balloon stops severe bleeding but is invasive and later in management. Pressure is the first, simpler action; packing escalates care unnecessarily before basic measures are tried in acute epistaxis.

Choice C reason: Silver nitrate cauterizes vessels, useful for persistent bleeding. It’s not first, requiring setup and assessment after pressure fails, as most epistaxis resolves with compression, making this a subsequent intervention.

Choice D reason: Squeezing nostrils compresses Kiesselbach’s plexus, stopping most anterior nosebleeds within 10 minutes. It’s the immediate, evidence-based first action, non-invasive, and effective, prioritizing rapid control before escalating to other methods.

A. Restrict fluids to 2 liters per day. B. Take a daily multivitamin with iron. C. Do not drink any caffeinated beverages. D. Limit exposure to crowds.

Correct Answer is D

Explanation

Choice A reason: Restricting fluids to 2 liters per day increases blood viscosity in sickle cell disease, promoting sickling and vaso-occlusion. Adequate hydration is critical to dilute hemoglobin S, so this instruction contradicts evidence-based management for crisis prevention.

Choice B reason: Iron supplements are contraindicated in sickle cell disease unless anemia is iron-deficient, which is rare. Most patients have normal or high iron from hemolysis, so a multivitamin with iron risks overload and organ damage.

Choice C reason: Avoiding caffeine lacks evidence in sickle cell crisis prevention; it’s not a trigger. Moderate intake doesn’t dehydrate significantly or affect sickling, making this instruction irrelevant to discharge teaching for this condition.

Choice D reason: Limiting crowd exposure reduces infection risk, a common sickle cell crisis trigger. Infections cause inflammation and hypoxia, promoting sickling, so this instruction aligns with preventing complications and maintaining patient stability post-discharge.

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Dr. Whitten just evaluated Ms. Sanchez and has written the following orders: Choose which order must be completed first.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which action would the nurse take first when a patient develops epistaxis (nose bleed)?

Correct Answer is D

Explanation

Which instruction will the nurse plan to include in discharge teaching for a patient who was admitted with a sickle cell crisis?

Correct Answer is D

Explanation

The nurse is reviewing the patient’s recent symptoms and lab results. Which of the following symptoms or findings suggest worsening heart failure? (Select all that apply)

Which potential complication would the nurse identify as a high risk for a patient admitted to the hospital with pancytopenia? (Select all that apply)

Based on the patient’s medication list, which of the following medications directly treat hypertension? (Select all that apply)

Many hospitalized patients are at risk for developing VTE.

The nurse is reviewing the patient’s history and recent lab results. Which of the following findings indicate an increased risk for cardiovascular complications? (Select all that apply)

Complete the following sentence: Given the patient’s symptoms of dyspnea and fatigue, the nurse anticipates the primary care provider may increase the dose of (medication class) to help reduce fluid overload.

Interpret the ABG results: pH: 7.48, PaCO2: 28 mmHg, PaO2: 55 mmHg, HCO3-: 24 mEq/L, SaO2: 87%

After 2 months of prescribed treatment with isoniazid, rifampin, pyrazinamide, and ethambutol, a patient continues to have positive sputum smears for acid-fast bacilli (AFB). Which action would the nurse take next?