The nurse is caring for a client who has been wearing a nitroglycerin patch and receives an order to start a nitroglycerin intravenous Infusion. The old patch must be removed from the client's body in order to avoid:

skin irritation.

interactions with other medications.

drug overdose.

loss of the patch.

Answer and Explanation

The Correct Answer is C

Choice A rationale: Skin irritation is a possible side effect of nitroglycerin patches, but it is not the primary reason for removing the patch in this situation.

Choice B rationale: Interactions with other medications are not the primary concern when transitioning from a patch to an intravenous infusion.

Choice C rationale: The removal of the nitroglycerin patch is necessary to avoid drug overdose when starting an intravenous infusion.

Choice D rationale: The loss of the patch is not the primary concern; rather, it is the potential for an overdose.

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Correct Answer is B

Explanation

Choice A rationale: Poor tissue perfusion from circulatory insufficiency can affect oxygenation, but fluid in the lungs primarily impacts gas exchange at the alveolar level.

Choice B rationale: Decreased diffusion of oxygen from the alveoli to the blood is a major factor affecting oxygenation when fluid is present in the lungs.

Choice C rationale: Lowered oxygen carrying capacity can affect oxygenation but is not the primary concern in the presence of fluid in the lungs.

Choice D rationale: Decreased concentration of oxygen in the air is not the primary factor affecting oxygenation in a client with fluid in the lungs.

A. Instruct client to shift their weight at least every 15 minutes B. Keep head of bed raised at 45 degrees at all times C. Massage over bony prominences every hour while awake D. Apply moisture barrier cream to perineal skin E. Consult with the wound care nurse about use of a specialty mattress

Correct Answer is ["A","D","E"]

Explanation

Choice A rationale: Instructing the client to shift their weight at least every 15 minutes helps prevent pressure injuries.

Choice B rationale: Keeping the head of the bed raised at 45 degrees at all times is not a typical practice for preventing pressure injuries.

Choice C rationale: Massaging over bony prominences every hour while awake may not be recommended, as this can cause friction and shear, contributing to skin breakdown. Choice D rationale: Applying moisture barrier cream to perineal skin helps protect against skin breakdown from urinary incontinence.

Choice E rationale: Consulting with the wound care nurse about the use of a specialty mattress can provide additional support and help prevent pressure injuries.

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The nurse is caring for a client who has been wearing a nitroglycerin patch and receives an order to start a nitroglycerin intravenous Infusion. The old patch must be removed from the client's body in order to avoid:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse understands that the major factor affecting oxygenation in a client who has fluid in the lungs is:

Correct Answer is B

Explanation

Correct Answer is ["A","D","E"]

Explanation

A one-day post-operative client complains of severe abdominal pain and has shallow respirations at 22/minute. The client is reluctant to perform coughing and deep breathing. Based on the data, the priority problem that the nurse could assign to this patient is:

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