The nurse is reviewing the patient's record. Select to highlight the findings that demonstrate that the patient is improving.

1430: Nurses' Note: Urine output 50 mL/hr dark amber color. Continues to be lethargic.

1430: Vital Signs: Temp 100.4°F (37.8°C) HR 110 bpm: regular RR 24 breaths/min: rapid, deep SpO2 98% on room air BP 94/56 mm Hg

1430: Labs: Glucose 460 mg/dl

HR 110 bpm

regular RR 24 breaths/min

BP 94/56 mm Hg

Glucose 460 mg/dl

Answer and Explanation

The Correct Answer is ["A","B","C","D"]

HR: 110 bpm; regular - The heart rate has decreased from 115 bpm and is now regular, suggesting improved cardiac rhythm stability.

RR: 24 breaths/min; rapid, deep - The respiratory rate has decreased from 26 breaths/min, indicating less rapid breathing.

BP: 94/56 mm Hg - While the blood pressure remains relatively low, there is a slight improvement compared to the previous reading.

Glucose 460 mg/dl - The glucose level has decreased from 525 mg/dL and 530 mg/dL in previous readings. While still elevated, this indicates some improvement in hyperglycemia.

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

B. A decrease in the respiratory rate from 32 breaths/minute to 20 breaths/minute indicates improved respiratory status and effectiveness of nursing care. A lower respiratory rate suggests that the patient's breathing is becoming less labored, and oxygenation may be improving.
A. A lower heart rate may suggest a reduction in pain, improved oxygenation, or decreased stress on the cardiovascular system. However, other factors such as medications, rest, and hydration can also influence heart rate. Overall, a decrease in heart rate is a favorable finding.
C. A slight decrease in blood pressure from 140/80 mm Hg to 130/78 mm Hg may indicate a positive response to nursing care. However, blood pressure fluctuations can be influenced by various factors, including hydration status, medications, and underlying medical conditions.
D. Pain management is an essential aspect of nursing care, particularly for patients with lower respiratory infections who may experience discomfort due to coughing, chest congestion, and inflammation. However, pain levels can fluctuate over time and may require ongoing assessment and intervention.

Correct Answer is ["2.5"]

Explanation

Volume= Desired dose/ Available concentration per ml Available concentration per ml= 40mg/ 5ml

Available concentration= 8mg/ml Desired dose= 20mg

Volume= 20mg/ 8mg Volume= 2.5ml

Therefore, the nurse should administer 2.5ml of famotidine.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is preparing to administer liquid famotidine 20 mg PO every 6 hr for GERD. Available is famotidine 40 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["2.5"]

Explanation

Which time would be ideal for the LPN/LVN to collect a sputum specimen?

Management of asthma involves avoidance of triggers. Which environmental triggers will the nurse suggest the patient eliminate? Select all that apply. (Select All that Apply.)

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Which patient does the LPN/LVN identify at high risk for hospital-acquired pneumonia?

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