The nurse supervisor is working in a hospital that is in the path of a hurricane. Which of the following clients would be appropriate for immediate discharge?

A client with lymphoma receiving inpatient chemotherapy.

A client with heart failure with crackles bilaterally on 4 liters of oxygen.

A client who is post-appendectomy with a paralytic ileus.

A client with a nondisplaced tibia fracture that has been immobilized.

Answer and Explanation

The Correct Answer is D

Choice A reason: A client with lymphoma receiving inpatient chemotherapy is likely to require close monitoring and ongoing treatment due to the potential complications associated with their condition and treatment. Discharging this client could put them at significant risk.

Choice B reason: A client with heart failure with crackles bilaterally on 4 liters of oxygen needs continuous medical supervision and care to manage their heart condition and oxygen levels. Discharging this client could exacerbate their heart failure and lead to serious health complications.

Choice C reason: A client who is post-appendectomy with a paralytic ileus is at risk of complications such as bowel obstruction and infection. They need to be closely monitored in the hospital until their condition stabilizes and they begin to recover from surgery.

Choice D reason: A client with a nondisplaced tibia fracture that has been immobilized is generally stable and can be safely discharged with appropriate instructions for home care. This client does not require intensive monitoring and can continue their recovery at home.

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Correct Answer is B

Explanation

Choice A reason: The red category in the START triage system is assigned to clients who require immediate life-saving intervention. Although this client is in pain and has severe symptoms, their respiratory rate, pulse, and capillary refill are normal, indicating that they do not need immediate life-saving intervention.

Choice B reason: The yellow category is designated for clients whose condition is stable but requires observation. This client is awake, alert, and oriented, with a normal respiratory rate, good radial pulse, and normal capillary refill. While they have severe abdominal pain and nausea, their condition does not appear to be life-threatening, making yellow the appropriate triage level.

Choice C reason: The black category is used for clients who are deceased or have injuries so severe that they are not expected to survive even with immediate medical intervention. This client is stable and responsive, so they do not fall into this category.

Choice D reason: The green category is for clients with minor injuries who can walk and do not require urgent medical attention. Since this client has severe symptoms and needs medical attention, the green category is not appropriate.

A. The client sits up and leans over the night table. B. The client's respiratory rate is 8 breaths/min. C. The client is noted to have a large barrel chest. D. The client's lungs have fine bibasilar crackles on auscultation.

Correct Answer is B

Explanation

Choice A reason: This posture, known as the tripod position, is common among clients with emphysema as it helps them breathe more easily by using accessory muscles. While it indicates respiratory distress, it is not immediately life-threatening.

Choice B reason: A respiratory rate of 8 breaths/min is significantly below the normal range (12-20 breaths/min) and indicates hypoventilation, which can lead to life-threatening conditions such as hypercapnia (elevated carbon dioxide levels in the blood). This finding needs immediate attention from the provider.

Choice C reason: A barrel chest is a common physical finding in clients with chronic emphysema. It develops over time due to hyperinflation of the lungs but is not an urgent finding that needs immediate reporting.

Choice D reason: Fine bibasilar crackles can indicate fluid accumulation in the lungs or other lung pathology, but this finding alone does not necessarily require immediate intervention unless accompanied by other critical symptoms.

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The nurse supervisor is working in a hospital that is in the path of a hurricane. Which of the following clients would be appropriate for immediate discharge?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The nurse is assessing a client with a diagnosis of acute emphysema. The client is receiving oxygen at a flow rate of 5 L/min by nasal cannula. Which assessment findings should be reported to the provider immediately?

Correct Answer is B

Explanation

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