The client is a 49-year-old who reports flu-like symptoms including fever and chest congestion for 4 days. He came to the emergency department (ED last night when he was having more difficulty breathing. He has a history of one-half pack a day cigarette smoking for 20 years. He has no significant medical or surgical history

The client has an oxygen saturation of 96% on 8 L simple face mask. The nurse assesses the client, and he is feeling less restless and anxious. His heart rate is now 79 bpm, blood pressure 119/73 mmHg, and respiratory rate 24.

What are the 3 most important goals that would help the nurse evaluate the treatment of this client at discharge?

The client will report pain less than 3/10

The client will have quit smoking

The client will remain free of skin breakdown

The client will maintain oxygen saturation of 96% without supplemental oxygen

The client will be afebrile for 24 hours

Answer and Explanation

Correct Answer : B,D,E

A. While managing pain is important, the client did not report significant pain, making it a lower priority in this scenario.
B. Quitting smoking is crucial for the client's respiratory health, especially given the history of smoking and current respiratory symptoms.
C. There is no indication that the client is at risk of skin breakdown; thus, it is not a priority in the immediate discharge plan.
D. Maintaining an oxygen saturation of 96% without supplemental oxygen is a direct indicator of improved respiratory function and a key goal for discharge.
E. Being afebrile for 24 hours would indicate that the infection is under control, which is a primary concern for discharge after presenting with flu-like symptoms.

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Correct Answer is B

Explanation

A. While psychological support may be beneficial for managing chronic pain, arranging a consultation with a psychologist may not directly address the client's immediate need for pain management.

B. Fibromyalgia is a chronic pain condition, and a pain specialist is best equipped to assess and manage the client's pain effectively. Therefore, arranging an appointment with a pain specialist is the most appropriate intervention.

C. Hospice care is typically reserved for end-of-life care and may not be suitable for a client with fibromyalgia unless the condition is terminal.

D. Forming an interdisciplinary team may be helpful for comprehensive care but may not directly address the client's immediate need for pain management.

A. Initiate seizure precautions. B. Monitor serum potassium frequently. C. Assess pupillary response to light hourly. D. Measure urinary output every hour.

Correct Answer is D

Explanation

A. Initiate seizure precautions: Dopamine administration does not typically require seizure
precautions. The focus should be on monitoring for adverse effects related to blood pressure and urinary output.
B. Monitor serum potassium frequently: While electrolyte imbalances can occur with dopamine administration, the priority is to monitor urinary output as dopamine affects renal perfusion and urine output.
C. Assess pupillary response to light hourly: Monitoring pupillary response is important in some situations, but it's not the primary concern with dopamine administration.
D. Measure urinary output every hour: Correct! Dopamine is administered to improve renal perfusion and increase urine output in hypotensive patients. Monitoring urinary output every
hour is essential to assess the effectiveness of dopamine therapy and detect any signs of renal dysfunction or worsening hypotension.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A female client with fibromyalgia asks the nurse to arrange for hospice care to help her manage the severe, chronic pain. Which intervention should the nurse provide to address the client's problem?

Correct Answer is B

Explanation

A client who is hypotensive is receiving dopamine, an adrenergic agonist, IV at the rate of 6 mcg/kg/min. Which intervention should the nurse implement while administering this medication?

Correct Answer is D

Explanation

When preparing to administer a prescribed medication to a homeless male at a community psychiatric clinic, the client tells the nurse that he usually takes a different dosage. Which action should the nurse take?

The nurse is educating a client about essential hypertension prevention. Which information should the nurse provide? (Select all that apply.)

The nurse leading a care team on a medical surgical unit is assigning client care to a practical nurse (PN) and an unlicensed assistive personnel Which task should the nurse assign to the PN?

A child with peripheral edema who weighs 44 pounds receives a prescription for furosemide 2 mg/kg intravenously every 12 hours. The vial is labeled, "10 mg/mL." How many mL should the nurse administer? (Enter numeric value only)

The nurse is performing a routine assessment of an IV site for a client receiving both IV fluids and medications through the line. The client reports tenderness when the nurse touches the arm above the site. Which finding should the nurse expect which will require immediate intervention?

A male client reports to the on-call clinic nurse that he took tadalafil 10 mg by mouth two hours ago and his skin now feels flushed. He reports a history of stable angina but denies experiencing any current or recent chest pain. Which action should the nurse take?