The nurse continues to assist with the care of the client.
Which of the following findings indicates that the client's condition has improved?
Select all that apply.
Fluid intake
Temperature
Wound findings
Pain level
Report of nausea
Bowel sounds
Correct Answer : D,E,F
A. Fluid intake: While fluid balance is important, there is no specific information indicating that changes in fluid intake are an indicator of the client’s condition improving in this context.
B. Temperature: The client's temperature has increased from 38.3°C (101°F) on Day 1 to 39.2°C (102.5°F) on Day 4. An increase in temperature indicates a possible infection or ongoing inflammation and does not suggest an improvement in the client’s condition.
C. Wound findings: There are no documented wound findings in the given notes. Thus, wound findings are not applicable in determining whether the client’s condition has improved in this scenario.
D. Pain level: The client's pain level has decreased from 7 to 3, indicating improvement.
E. Report of nausea: The client reports feeling less nauseous and has not vomited since yesterday, which is a sign of improvement.
F. Bowel sounds: The bowel sounds are more regular and less high-pitched, suggesting improvement in gastrointestinal function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hypernatremia: Excessive fluid loss through sweat, combined with insufficient fluid intake, can lead to hypernatremia (elevated sodium levels), often seen in heat exhaustion.
B. Hypocalcemia: Calcium levels are not typically affected by heat exhaustion.
C. Hyperkalemia: Potassium levels usually decrease due to sweating, not increase.
D. Hyperphosphatemia: Phosphate levels are not significantly altered in heat exhaustion.
Correct Answer is C
Explanation
A. "Insert an indwelling urinary catheter and record the client's output.": This is not relevant to a thoracentesis, which focuses on the pleural cavity, not urinary output.
B. "Set up the equipment using clean technique.": Sterile technique is required to prevent infection during the invasive procedure.
C. "Prepare the client for a chest x-ray following the procedure.": A chest x-ray is performed post-thoracentesis to ensure the lung has re-expanded and to rule out complications like pneumothorax.
D. "Instruct the client to remain flat in bed for 4 to 6 hr after the procedure.": The client does not need to remain flat; instead, they are typically observed for respiratory complications in a sitting or semi-Fowler’s position.
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