Patient Data

Exhibits

New data is reviewed.

Choose the most likely options for the information missing from the statements by selecting from the lists of options provided.

This client is exhibiting signs of
dropdown
. The nurse is a mandated reporter and therefore must report the elder mistreatment to
dropdown
.

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}

Rationale for Correct Choices

Neglect: The client presents with signs of poor hygiene, untreated pressure injuries, confinement to bed without a clear medical reason, and a reduction in social interaction and autonomy. These factors collectively indicate neglect, which is the failure of a caregiver to meet the basic physical, emotional, and social needs of a dependent adult.
Adult Protective Services: Adult Protective Services is the appropriate authority to report suspected abuse or neglect of older adults living in private homes. As a mandated reporter, the nurse is legally required to report suspected elder mistreatment to APS to initiate an investigation and protect the client.

Rationale for Incorrect Choices

Sexual abuse: There are no indicators such as bruising in private areas, fear of the caregiver, or behavioral cues that might suggest sexual trauma. The case centers on physical neglect, not sexual abuse.
Financial exploitation: The client has not reported any unauthorized financial activity, and there is no evidence of the caregiver misusing or controlling the client’s finances. This makes financial exploitation an unlikely concern.
Long Term Care Program: This agency oversees long-term care facilities like nursing homes. Since the client resides in a private home, the situation falls outside the jurisdiction of this program.
State Department of Health: The Department of Health primarily monitors healthcare providers and facilities, not private caregiving situations. Therefore, it is not the correct agency to report suspected elder abuse in this context.

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Correct Answer is A

Explanation

Rationale:

A. Prevent injury: In CKD, high phosphate and low calcium levels contribute to bone demineralization, increasing fracture risk. Hypocalcemia can also cause muscle cramps and tetany, making fall prevention and safety a priority.

B. Prevent infection: While infection is a general concern in CKD, these specific lab findings do not indicate immunosuppression. The primary issue here relates to bone health and calcium-phosphate imbalance, not immune function.

C. Protect skin integrity: Skin care is important in CKD, especially with pruritus, but it is not the direct consequence of calcium-phosphate imbalance. The immediate risk related to these values is musculoskeletal, not dermatologic.

D. Manage fluid volume: Fluid volume control is essential in CKD but unrelated to phosphate-calcium shifts. These labs reflect mineral and bone metabolism disturbances, not volume overload or deficit.

A. Assess for fatty yellow streaks in the client's stool. B. Obtain a specimen for culture and sensitivity analysis. C. Send a stool sample to the lab for a guaiac test. D. Observe the stool for a clay-colored appearance.

Correct Answer is C

Explanation

Rationale:

A. Assess for fatty yellow streaks in the client's stool: This suggests steatorrhea, commonly linked to malabsorption syndromes—not relevant to recent thrombolytic use or bleeding risk.

B. Obtain a specimen for culture and sensitivity analysis: This is used to identify infectious organisms in cases of suspected gastrointestinal infection, not bleeding, which is the primary concern post-thrombolytic therapy.

C. Send a stool sample to the lab for a guaiac test: A guaiac test detects occult (hidden) blood in stool, which is essential for identifying gastrointestinal bleeding—a major complication of thrombolytic therapy.

D. Observe the stool for a clay-colored appearance: Clay-colored stool may indicate biliary obstruction or liver dysfunction, not a bleeding issue, which is the critical concern after thrombolytic administration.

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Naxlex Comprehensive Predictor Exams

In caring for a client with chronic kidney disease (CKD), the nurse notes that the client's serum phosphate level is elevated, with a converse decrease in serum calcium. Which nursing care goal is a priority, based on these laboratory findings?

Correct Answer is A

Explanation

A client received a thrombolytic medication following a myocardial infarction. When the client has a bowel movement, which action should the nurse implement?

Correct Answer is C

Explanation

A client who has been taking colchicine calls the clinic with reports of an acute gout attack of the right great toe. The client has a history of kidney stones and esophageal reflux. Which finding warrants immediate intervention by the nurse?

The first paddle has been placed on the chest of a client who needs defibrillation. Where should the nurse place the second paddle? (Mark the location where the second paddle should be placed on the image)

A group of nurses implement a pilot study to evaluate a proposed evidence-based change to providing client care. Evaluation indicates successful outcomes and the nurses want to integrate the change throughout the facility. Which actions should be taken? Select all that apply.

Patient Data Exhibits The nurse reviews the findings in the history and physical. Drag from Word Choices to complete the sentence. The nurse recognizes that dropdown , dropdown and dropdown are findings consistent with elder mistreatment.

Which dietary intervention(s) should the nurse include in the plan of care for a client who had bariatric surgery? Select all that apply.

A client who weighs 110 lb receives a prescription for dalteparin 150 units/kg SUBQ daily for 4 months. The medication is available in 7,500 units/0.3 mL prefilled syringe. How many mL should the nurse administer? (Enter numerical value only.)