Exhibits
A nurse is reviewing the medical record of a client who has COPD. The nurse should notify the provider about which of the following findings? (Click on the exhibit tabs for additional information about the client. There are three tabs that contain separate categories of data.)

SpO2

Respiratory rate

Temperature

Answer and Explanation

The Correct Answer is B

Rationale:

A. SpO₂: Although 88% is low for the general population, it is often an acceptable baseline for clients with COPD. Their oxygen saturation targets are typically between 88–92% to avoid suppressing respiratory drive, so this value may not require immediate provider notification.

B. pH: A pH of 7.22 indicates respiratory acidosis, which is a serious and potentially life-threatening complication of COPD. This level of acidosis shows that the client’s ventilation is inadequate, and immediate intervention is needed. This is the most critical finding that requires provider notification.

C. Respiratory rate: A rate of 22 breaths/min is slightly elevated but not critical. It may be compensatory and expected in a COPD patient who is hypoxic or retaining CO₂. By itself, it doesn't warrant urgent notification unless it worsens.

D. Temperature: A temperature of 37.2°C (99°F) is within the normal range and does not indicate infection or acute illness. It is not a finding that necessitates notifying the provider at this point.

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Correct Answer is D

Explanation

Rationale:

A. A 25-gauge needle: A 25-gauge needle is too small and not designed for accessing implanted ports. Using such a needle may cause damage to the port septum and does not ensure reliable blood flow or medication administration.

B. An angiocatheter: Angiocatheters are used for peripheral venous access and are not suitable for accessing implanted ports. Their sharp tips can damage the septum of the port and compromise its integrity.

C. A butterfly needle: Butterfly needles are designed for short-term peripheral access. They are not appropriate for implanted ports and can damage the port’s self-sealing septum, leading to malfunction.

D. A noncoring needle: Noncoring (Huber) needles are specifically designed for accessing implanted venous ports. Their curved tip prevents coring of the port septum, reducing damage and maintaining the port’s function and sterility.

A. “I can infuse the medication at a faster rate” B. “I can start the medication 30 minutes earlier.” C. “I have up to 2 hours after the usual scheduled time to give you this medication “ D. “I can adjust the time and schedule for when it's convenient for you.”

Correct Answer is B

Explanation

Rationale:

A. “I can infuse the medication at a faster rate”: Vancomycin must be infused slowly, typically over 60–120 minutes, to prevent adverse effects such as Red Man Syndrome. Increasing the infusion rate is unsafe and not appropriate.

B. “I can start the medication 30 minutes earlier.” Medications such as IV antibiotics (including vancomycin) must be administered within an acceptable time window to maintain therapeutic drug levels and effectiveness. The standard safe administration window is typically ±30 minutes from the scheduled time. Therefore, giving the medication 2 hours early is not appropriate, but 30 minutes earlier is acceptable and safe.

C. “I have up to 2 hours after the usual scheduled time to give you this medication”: While some medications have extended windows, IV antibiotics like vancomycin require strict timing, and a 2-hour delay is not appropriate.

D. “I can adjust the time and schedule for when it's convenient for you.” While patient preferences are important, antibiotic timing must align with dosing schedules to maintain therapeutic levels. Adjustments must follow clinical guidelines, not personal convenience.

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ExhibitsA nurse is reviewing the medical record of a client who has COPD. The nurse should notify the provider about which of the following findings? (Click on the exhibit tabs for additional information about the client. There are three tabs that contain separate categories of data.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has an implanted venous access port. Which of the following should the nurse use to access the port?

Correct Answer is D

Explanation

A nurse is preparing to administer vancomycin IV to an adult client. The client asks the nurse if the medication can be given 2 hr earlier. Which of the following statements should the nurse make?

Correct Answer is B

Explanation

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Exhibits
A nurse is reviewing the medical record of a client who has COPD. The nurse should notify the provider about which of the following findings? (Click on the exhibit tabs for additional information about the client. There are three tabs that contain separate categories of data.)