Exhibits

The nurse reviews the client’s medical record from admission to 1930 hrs. Click to indicate whether the assessment finding has improved or not changed.

Dyspnea

Heart rate

Blood pressure

Oxygen saturation

Respiratory rate

Oral intake

Lung sounds

Answer and Explanation

The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"},"G":{"answers":"B"}}

Assessment Finding	Improved	No change
Dyspnea		✅
Heart rate	✅
Blood pressure	✅
Oxygen saturation	✅
Respiratory rate	✅
Oral intake	✅
Lung sounds		✅

Rationale:

Improved:

Heart rate and blood pressure are slightly improved by 1930, likely due to the medications (furosemide, enalapril) helping manage fluid retention and blood pressure.

Oral intake has improved, but monitoring of this is critical given the recent lack of eating for several days.

No change:

Dyspnea remains unchanged, since the adolescent is still dyspneic with activity.

Lung sounds remain unchanged, indicating that there may still be some wheezing or fluid buildup in the lungs.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Free Nursing Study Resources

Correct Answer is A

Explanation

Rationale:

A. Orthostatic hypotension (a significant drop in blood pressure when standing) could indicate a problem such as dehydration, hemorrhage, or shock and should be reported immediately.

B. Crying due to pain is common with burn injuries but does not indicate a life-threatening problem.

C. A pain increase after ambulation is expected in some cases but is not an emergency.

D. A mild temperature (99.5°F) postoperatively is not a cause for immediate concern.

A. Bananas B. Grapes C. Celery D. Raw carrots

Correct Answer is A

Explanation

A. Bananas are a safe food choice for a 2-year-old, as they are soft and easy to chew, reducing the risk of choking.

B. Grapes should be cut into smaller pieces to prevent choking, as they are a common choking hazard for young children.

C. Celery can be difficult for a toddler to chew and may pose a choking risk, especially if not cut properly.

D. Raw carrots are hard and may pose a choking risk, especially if not cut into small, manageable pieces.

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Exhibits The nurse reviews the client’s medical record from admission to 1930 hrs. Click to indicate whether the assessment finding has improved or not changed.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a group of adolescents. Which of the following findings should be reported to the provider immediately?

Correct Answer is A

Explanation

A nurse is teaching a parent of a 2-year-old child about safe food choices. Which of the following foods should the nurse recommend?

Correct Answer is A

Explanation

A nurse is creating a plan of care for a pediatric client who has been diagnosed with Duchenne muscular dystrophy (DMD). Which of the following factors should the nurse consider when planning care?

A nurse is creating a plan for a toddler who has minimal change nephrotic syndrome and 3+ pitting edema, which of the following interventions should the nurse include in the plan?

A nurse is providing anticipatory guidance about child development to the parents of a preschooler. Which of the following developmental tasks should the nurse include as being expected of a preschooler?

The nurse is administering desmopressin (DDAVP) to a pediatric client with diabetes insipidus. The nurse should monitor for which of the following potential side effects of this medication?

A hospice nurse is caring for a preschooler who has a terminal illness. The father tells the nurse that he cannot cope anymore and had decided to move out of the house. Which of the following statements should the nurse make?

A nurse is assessing an adolescent who experienced blunt trauma to the abdomen. Which of the following findings is the nurse's priority?

A nurse is assessing the pain level of a 3-year old toddler. Which of the following pain assessment scales should the nurse use?

A nurse is caring for a toddler. Which of the following statements should the nurse use when preparing to obtain the child's vital signs?

Exhibits

The nurse reviews the client’s medical record from admission to 1930 hrs. Click to indicate whether the assessment finding has improved or not changed.