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Patient Data

Exhibits

What order(s) would the nurse question? (Select all that apply.)

Send blood for a complete blood count, electrolytes

Enalapril 10 mg every morning

C Ibuprofen 400 mg every 4 to 6 hours PRN for temperature greater than 100.5°F (38° C)

Admit to the medical floor

Supplemental oxygen 10 L/min via nasal cannula

Vital signs every 4 hours

Continuous pulse oximetry

Chest x-ray

Answer and Explanation

Correct Answer : C,E,H

A. Send blood for a complete blood count, electrolytes: This is appropriate for assessing the client's overall health status and electrolyte balance, which may be affected by pneumonia and enalapril therapy.

B. Enalapril 10 mg every morning: This is the client's maintenance dose of enalapril for managing hypertension, and it should be continued unless there are specific contraindications or concerns about renal function.

C. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase blood pressure and interfere with the antihypertensive effects of enalapril. Additionally, NSAIDs can potentially worsen renal function, which may already be compromised in a client with pneumonia.
D. Admit to the medical floor: This is appropriate for a client with pneumonia who may require close monitoring and management of respiratory status and other complications.
E. Supplemental oxygen 10 L/min via nasal cannula: High-flow oxygen can decrease respiratory drive and potentially worsen ventilation-perfusion (V/Q) matching, especially in clients with pneumonia.

F. Vital signs every 4 hours: Regular monitoring of vital signs is essential for assessing the client's response to treatment and identifying any signs of deterioration.

G. Continuous pulse oximetry: Continuous pulse oximetry provides real-time monitoring of oxygen saturation and helps assess the effectiveness of oxygen therapy and the client's respiratory status.

H. While a chest x-ray is often indicated for diagnosing pneumonia, ordering it "now" may not be necessary unless the client's condition is unstable or if there are specific concerns regarding the severity of the pneumonia

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

B. This ensures that the tracheostomy tube remains stable and reduces the risk of the tube becoming dislodged during the process.
A. Tying knots close to the tracheostomy tube can increase the risk of pressure ulceration and irritation to the skin around the stoma.
C. A disposable, soft foam collar with self-adhesive fastening may be used for additional support and comfort, but it does not replace the need for securing the tracheostomy ties.
D. Placing knots laterally may not provide adequate support and can increase the risk of accidental displacement of the tracheostomy tube.

A. Auscultate the client's bowel sounds and measure the abdominal girth. B. Confirm that the client is taking the medication one hour after meals. C. Notify the healthcare provider that the client may need a change in dosage. D. Advise the client that healing typically takes several weeks to occur.

Correct Answer is D

Explanation

D. Since the client has reported only minimal reduction in symptoms after taking lansoprazole (a proton pump inhibitor used to treat GERD) for one full week, it suggests that the current dosage may not be sufficient for adequate symptom relief. Therefore, the nurse should notify the healthcare provider.

A. Auscultating the client's bowel sounds and measure the abdominal girth. This action is not directly related to the client's reported lack of symptom improvement with lansoprazole.

B. Lansoprazole is typically taken before meals to maximize its effectiveness in reducing gastric acid production.

C.While it is true that healing of erosive esophagitis may take several weeks with treatment, the client's report of minimal symptom reduction suggests that further evaluation and potentially a change in treatment approach are warranted.

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Patient Data Exhibits What order(s) would the nurse question? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who has had a laryngectomy and tracheostomy frequently expectorates copious amounts of purulent secretions. When changing the lies of the tracheostomy tube, which action is most important for the nurse to take?

Correct Answer is B

Explanation

A client who is newly diagnosed with erosive esophagitis secondary to gastroesophageal reflux disease (GERD) reports to the home health nurse that there has been only a minimal reduction in symptoms after taking lansoprazole PO for one full week. Which action should the nurse take?

Correct Answer is D

Explanation

A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

Which instruction should the nurse include in the discharge teaching plan for an adult client with hypernatremia?

A client with myasthenia gravis receives a new prescription for pyridostigmine. Which information should the nurse obtain to prior to administering the medication?

A client with emphysema reports difficulty breathing and exhibits audible wheezing. The nurse administers albuterol as prescribed for the third time within the last 12 hours. Which assessment finding warrants Immediate intervention by the nurse?

A client has been administered lactulose for several days. Which therapeutic response should the nurse expect for a client with hepatic encephalopathy?

An adult client with multiple sclerosis (MS) fell while walking to the bathroom. On transfer to the intensive care unit, the client is confused and has had projectile vomiting twice. Which intervention should the nurse implement first?

The nurse is performing a routine dressing change for a client with a stage 3 pressure injury that is red with significant granulation. The wound has a gauze dressing covering the area. Which action should the nurse implement?

Patient Data

Exhibits

What order(s) would the nurse question? (Select all that apply.)