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Exhibits

A nurse is reviewing the client’s condition. Based on the exhibits provided, what is the most likely diagnosis for this client?

. Hypovolemic shock and Puerperal infection

. Pulmonary embolism and postpartum hemorrhage

Acute myocardial infarction and postpartum hemorrhage

Pneumonia and Acute myocardial infarction

Answer and Explanation

The Correct Answer is B

The most likely diagnosis for this client is B. Pulmonary embolism and postpartum hemorrhage.

Here’s why:

Postpartum Hemorrhage:
- The client has a large amount of lochia rubra, indicating significant blood loss.
- Hemoglobin and hematocrit levels are low (7.5 g/dL and 22%, respectively), which is consistent with significant blood loss.
- Symptoms like feeling lightheaded, pale appearance, and cool, clammy skin further support this diagnosis.
Pulmonary Embolism:
- The client is experiencing shortness of breath, using accessory muscles to breathe, and has an oxygen saturation of 88% on room air.
- Elevated D-dimer levels (1.5 µg/mL) suggest the presence of a clot.
- Arterial Blood Gas (ABG) results show a low PaO2 (60 mmHg) and a slightly acidic pH (7.32), which can be seen in pulmonary embolism.
- The client reports a feeling of tightness in her chest and has a rapid heart rate (120 beats per minute), which are also indicative of a pulmonary embolism.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

Choice D rationale:

Highlights daily use: Tiotropium is a long-acting bronchodilator, meaning it works to relax and open the airways over an extended period. It's crucial for managing COPD symptoms and preventing exacerbations. Daily use is essential to maintain its effectiveness.

Emphasizes the Handihaler: The Handihaler is the specific inhalation device designed for tiotropium delivery. It ensures proper medication administration and optimal lung deposition.

Demonstrates understanding of instructions: Choosing this option indicates the client has correctly grasped the intended frequency and method of use.

Choice A rationale:

Misunderstanding of purpose: Tiotropium is not a rescue inhaler for sudden shortness of breath. It's a maintenance medication that works gradually to improve lung function. For acute symptoms, a short-acting bronchodilator, like albuterol, is required.

Potential delay in appropriate treatment: Reliance on tiotropium for acute episodes could lead to delayed use of the correct rescue medication, potentially worsening symptoms and increasing risks.

Choice B rationale:

Potential side effect, not primary goal: While tiotropium may reduce sputum thickness in some individuals, it's not the primary aim of therapy. Focusing on this aspect could overlook its broader benefits in managing COPD.

Variable response: The extent of sputum thinning varies among individuals and shouldn't be the sole indicator of effectiveness.

Choice C rationale:

Potential for overmedication: Using multiple inhalers without clear guidance from a healthcare provider could increase the risk of excessive medication and adverse effects.

Importance of individualized regimens: Inhaler use depends on the specific medications prescribed and the severity of COPD. Healthcare professionals tailor regimens to individual needs.

A. 50 mL/hr. B. 100 mL/hr. C. 150 mL/hr. D. 200 mL/hr.

Correct Answer is B

Explanation

Step 1: Identify the desired dose and the available concentration. Desired dose: 500 mg of vancomycin

Available concentration: 500 mg per 100 ml

Step 2: Determine the volume needed to deliver the desired dose.

Since the available concentration is 500 mg per 100 ml, no further calculation is required. The volume needed to deliver 500 mg of vancomycin is already 100 ml.

Step 3: Calculate the infusion rate in mL/hr.

The medication needs to be administered over 1 hour.

Therefore, the infusion pump should be set to deliver the 100 ml of solution over 1 hour. Infusion rate = 100 ml / 1 hour = 100 mL/hr.

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Exhibits A nurse is reviewing the client’s condition. Based on the exhibits provided, what is the most likely diagnosis for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client diagnosed with chronic obstructive pulmonary disease (COPD) is given a new prescription for tiotropium via an inhalation device.Which statement indicates that the client understands the instructions for using this medication?

Correct Answer is D

Explanation

A client receives a prescription for vancomycin 500 mg IV every 8 hours. The medication is provided in "500 mg per 100 ml" of dextrose 5% in water. To administer the medication over an hour, the nurse should set the infusion pump to deliver how many mL/hr?

Correct Answer is B

Explanation

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Exhibits

A nurse is reviewing the client’s condition. Based on the exhibits provided, what is the most likely diagnosis for this client?