The practical nurse (PN) is planning evening shift rounds for a group of postoperative clients who all had surgery earlier that day. Which client should the PN check first?
A preschooler who had an emergency appendectomy for appendicitis.
An adult with osteomyelitis who had a necrotic bone fragment removed in the foot.
A post-menopausal client with breast cancer who had a right breast lumpectomy.
An adolescent with type 1 diabetes (DM) who had an open cholecystectomy.
The Correct Answer is A
A. A preschooler who had an emergency appendectomy should be checked first. Children are at higher risk for complications due to their size and the stress of emergency surgery, so close monitoring is essential.
B. An adult with osteomyelitis post-surgery is important to monitor but is generally at lower immediate risk compared to a young child following emergency surgery.
C. A post-menopausal client with breast cancer who had a lumpectomy is also a priority, but the immediate postoperative period for a child in emergency surgery takes precedence.
D. An adolescent with type 1 diabetes who had cholecystectomy requires careful monitoring, but the child’s higher risk in the immediate postoperative phase makes them the priority.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Assigning the UAP to more stable clients does not address the immediate issue of the protocol omission and does not ensure that the protocol is followed correctly in the future.
B. Completing an unusual occurrence report is not necessary if the omission was corrected and the situation does not involve a significant error or safety issue.
C. Reporting to the charge nurse may be appropriate, but the priority is to ensure the UAP understands and follows the protocol, which is best achieved through direct supervision.
D. Supervising the UAP and reviewing the protocol ensures that the UAP understands and adheres to the fall prevention protocol moving forward, addressing both the immediate issue and future adherence.
Correct Answer is B
Explanation
A. NSAIDs are not associated with the characteristic features of truncal obesity, moon face, and buffalo hump.
B. Corticosteroids can cause truncal obesity, moon face, and buffalo hump as side effects due to their effects on metabolism and fat distribution.
C. Thyroid replacement hormone is used to treat hypothyroidism and does not cause the symptoms described.
D. Insulin is used to manage diabetes and does not typically cause the features seen in Cushing’s syndrome associated with corticosteroid use.
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