Exhibits

Based on the assessment and blood gas results, which 3 orders should the nurse expect from the healthcare provider?

Give a bolus of 1,000 mL 0.9% sodium chloride

Repeat blood gas in 1 hour

Place the client in a prone position

Perform endotracheal suctioning

Chest x-ray now

Administer inhaled corticosteroid

Answer and Explanation

Correct Answer : B,C,D

A. Giving a bolus of 1,000 mL 0.9% sodium chloride is typically used to treat hypovolemia or electrolyte imbalances, which are not indicated by the patient's current lab values or clinical
situation.
B. Repeating the blood gas in 1 hour is a reasonable order as it would provide information on whether the patient's respiratory status is improving following interventions for ventilator-associated pneumonia.
C. Placing the client in a prone position can improve oxygenation in patients with respiratory distress by redistributing lung perfusion, making it a suitable intervention for this patient with diminished breath sounds and crackles.
D. Performing endotracheal suctioning would help clear secretions, which may be contributing to the patient's diminished breath sounds and crackles, and is consistent with the care for a patient with pneumonia.
E. A chest x-ray now would typically be ordered if there was a suspicion of a new onset condition such as a pneumothorax or pleural effusion, which is not indicated by the patient's current presentation.
F. Administering an inhaled corticosteroid is generally used for long-term management of chronic respiratory conditions and is not typically used for acute management of ventilator-associated pneumonia.

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Correct Answer is B

Explanation

The initial sterile wound care for surgical clients requires an assessment of the wound's appearance and healing, which is the responsibility of the RN. PNs can provide ongoing wound care but not the first assessment.

Validating prescribed IV flow rates is within the scope of practice for a PN. This task involves observation and monitoring, which PNs are trained to perform safely and effectively.

C. Initiating teaching for client care after discharge involves comprehensive assessment, planning, and communication skills, which are typically performed by an RN.
D. Evaluating and updating plans of care for clients requires critical thinking, clinical judgment, and decision-making skills, which are typically performed by an RN.

A. What drugs the client used for the suicide attempt. B. When the client last took drugs for bipolar disorder. C. Whether the client ever attempted suicide in the past. D. Which family member has the client's suicide note.

Correct Answer is A

Explanation

A. What drugs the client used for the suicide attempt: Knowing the specific medications taken during the suicide attempt is crucial for assessing potential overdose effects, determining appropriate treatment interventions, and predicting potential complications.
B. When the client last took drugs for bipolar disorder: While important for understanding the client's medication history and potential interactions, the immediate concern is addressing the overdose and ensuring the client's safety.
C. Whether the client ever attempted suicide in the past: Past suicide attempts are significant in assessing suicide risk, but the immediate focus should be on the current overdose and ensuring the client's safety.
D. Which family member has the client's suicide note: While involving family members may be important for providing support and gathering information, the priority is addressing the client's immediate medical needs resulting from the overdose.

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Exhibits Based on the assessment and blood gas results, which 3 orders should the nurse expect from the healthcare provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After receiving a change of shift report for clients on a medical-surgical unit, which activity should the nurse delegate to the practical nurse (PN)?

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Explanation

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Explanation

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Exhibits

Based on the assessment and blood gas results, which 3 orders should the nurse expect from the healthcare provider?