The nurse is caring for a patient with respiratory problems. Which assessment finding indicates a late sign of hypoxia?

Elevated blood pressure

Increased pulse rate

Cyanosis

Restlessness

Answer and Explanation

The Correct Answer is C

A. Elevated blood pressure may occur with various conditions but is not a specific late sign of hypoxia.
B. An increased pulse rate can be an early compensatory response to hypoxia rather than a late sign.
C. Cyanosis, which is a bluish discoloration of the skin and mucous membranes, is a classic late sign of hypoxia, indicating severe oxygen deprivation.
D. Restlessness may indicate early signs of hypoxia or anxiety rather than a late sign and can occur before cyanosis develops.

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Correct Answer is B

Explanation

A. Atelectasis is prevented primarily through deep breathing exercises and respiratory interventions, not passive ROM.
B. Passive ROM and splinting help prevent joint contractures by maintaining joint mobility and alignment, so the absence of contractures indicates successful prevention.
C. Pressure ulcers are avoided through regular repositioning and skin care rather than passive ROM alone.
D. Renal calculi are primarily prevented through hydration and diet, not passive ROM or splinting.

A. Burnout and secondary traumatic stress B. Lateral violence and intrapersonal conflict C. Physical and mental exhaustion D. Short-term grief and single stressor

Correct Answer is A

Explanation

A. Compassion fatigue is characterized by burnout and secondary traumatic stress, which result from prolonged exposure to caring for patients in distress and trauma, leading to emotional exhaustion.
B. Lateral violence and intrapersonal conflict involve hostile behavior and internal personal issues, which do not define compassion fatigue.
C. While physical and mental exhaustion can occur with compassion fatigue, they are not the defining aspects without the context of prolonged trauma exposure.
D. Short-term grief and a single stressor do not capture the chronic nature of compassion fatigue, which builds over repeated exposure to others' suffering.

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The nurse is caring for a patient with respiratory problems. Which assessment finding indicates a late sign of hypoxia?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is performing passive range of motion (ROM) and splinting on an at-risk patient. The absence of which finding will indicate goal achievement for the nurse's action?

Correct Answer is B

Explanation

A nurse has compassion fatigue. What is the nurse experiencing?

Correct Answer is A

Explanation

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