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Patient Data

Exhibits

The client has recovered from surgery and is ready to be discharged.

Highlight findings that indicate the client is stable and ready to be discharged.

The client returned from appendectomy surgery last night at approximately 2100. The client was admitted for observation due to a delay in waking from anesthesia. The client is currently resting in bed. The incision dressing is dry and intact, and no bleeding is noted. The client tolerated clear liquids post recovery and has advanced to a soft diet. The client ambulated around the unit this morning and tolerated activity well. Bowel sounds are present in all 4 quadrants, and per client report, she has passed flatus. Pain is tolerated with analgesia PO.

The client returned from appendectomy surgery last night at approximately 2100. The client was admitted for observation due to a delay in waking from anesthesia.

The incision dressing is dry and intact, and no bleeding is noted.

The client tolerated clear liquids post recovery and has advanced to a soft diet.

The client ambulated around the unit this morning and tolerated activity well.

Bowel sounds are present in all 4 quadrants, and per client report, she has passed flatus. Pain is tolerated with analgesia PO.

The client is currently resting in bed.

Answer and Explanation

The Correct Answer is ["B","C","D","E"]

• Incision dressing is dry and intact, with no bleeding: Indicates proper wound healing and absence of complications such as infection or hemorrhage. A clean, dry surgical site is a key criterion for safe discharge.

• Tolerated clear liquids and advanced to soft diet: Shows that the gastrointestinal system is functioning post-anesthesia and surgery. Tolerance of oral intake without nausea, vomiting, or abdominal discomfort is essential before discharge.

• Ambulated around the unit and tolerated activity well: Demonstrates that the client has regained baseline mobility, which reduces risk of postoperative complications like atelectasis or DVT. Ability to mobilize is a standard requirement for safe discharge.

• Bowel sounds present in all four quadrants; passing flatus: Confirms the return of peristalsis and bowel function, which is necessary before discharge after abdominal surgery. Passing gas is an expected milestone indicating GI recovery.

• Pain controlled with oral analgesia: Suggests that the client’s pain is manageable without IV medication. Effective pain control at home using oral medications supports comfort and reduces the risk of readmission.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

A. The client will express acceptance of his changing health status: Emotional acceptance is important but is not a specific, measurable outcome directly related to managing complications like blurred vision in a client with diabetes.

B. The client's family will state signs and symptoms about the disease: Educating the family is beneficial, but the priority outcome should focus on the client's personal health goals and clinical measures to protect vision and prevent further complications.

C. The client's daily blood pressure will be less than 140/80 mm Hg this month: Tight blood pressure control is essential in preventing or slowing the progression of diabetic retinopathy and other microvascular complications that can lead to vision loss.

D. The nurse will demonstrate the procedure for accurate eye care: While the nurse's demonstration is important for teaching, the plan of care should focus on client-centered outcomes, not on the nurse’s actions.

A. Position bedside table so the client can lean across it. B. Encourage rest until the analgesic becomes effective. C. Raise head of bed until to a 90 degree angle. D. Place bed in a reverse trendelenburg position.

Correct Answer is A

Explanation

A. Position bedside table so the client can lean across it: Leaning forward, or assuming a tripod position, can help relieve pressure on the inflamed pancreas and ease epigastric pain, so positioning a bedside table for support offers comfort and facilitates better breathing.

B. Encourage rest until the analgesic becomes effective: Although rest is beneficial, simply encouraging the client to wait disregards their active attempts to find a position that eases their pain, potentially worsening discomfort and anxiety.

C. Raise head of bed until to a 90 degree angle: Elevating the head of the bed may provide partial relief but does not offer the same effectiveness as allowing the client to lean forward, which specifically reduces intra-abdominal pressure.

D. Place bed in a reverse trendelenburg position: Reverse Trendelenburg reduces pressure on abdominal organs by elevating the head and torso, but it is less effective for relieving pancreatitis-related pain compared to leaning forward with upper body support.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is developing a plan of care for an older male client with type 2 diabetes who reports blurred vision. Which outcome should the nurse include in the plan of care for this client?

Correct Answer is C

Explanation

A client with pancreatitis reports severe epigastric pain, so the nurse administers a prescribed narcotic analgesic. Ten minutes later, the client insists on sitting up and leaning forward. Which intervention should the nurse implement?

Correct Answer is A

Explanation

A client with Parkinson's disease (PD) is admitted to the medical surgical unit and the nurse assesses the client's mobility needs. Which finding(s) indicate the need to plan interventions related to the client's mobility? Select all that apply.

The nurse is teaching a female client about preventive measures for urinary tract infections (UTI). Which information should the nurse include?

The nurse is working on an infectious disease unit. Which client should be assigned to a room with negative airflow, while requiring personnel to use a particulate respirator mask, and requiring staff to observe airborne, as well as standard precautions?

After inflating a blood pressure cuff and releasing the valve, the nurse hears silence followed by a Korotkoff sound. Which action should the nurse take next?

The client who has emphysema and recently experienced a stroke receives a prescription for a metered-dose inhaler with a spacer device. The client asks the nurse if using the spacer is necessary. Which information should the nurse provide?

The nurse is preparing to administer a formula feeding by nasogastric tube (NGT) to a 2-month-old. Which intervention should the nurse implement?

Client data Complete the table by matching each client data to the appropriate goal of care

Following a cardiac catheterization and placement of a stent in the right coronary artery, the nurse administers prasugrel to the client. To monitor for adverse effects from the medication, which assessment is most important for the nurse to include in this clients plan of care?