The practical nurse (PN) receives prescriptions from the healthcare provider. Click to highlight the 3 prescriptions that the PN should perform right away.

A. Acetaminophen 600 mg PO every 6 hours PRN for pain or temperature greater than 100° F (37.7° C)
B. Contact precautions
C. Vancomycin 500 mg IV piggyback every 6 hours
D. Place peripheral IV
E. Change turban dressing by cleansing with sterile water, patting dry, applying dry gauze over incision, and wrapping head with kerlix
F. Strict intake and output
G. Clear liquid diet

Acetaminophen 600 mg PO every 6 hours PRN for pain or temperature greater than 100° F (37.7° C)

Contact precautions

Vancomycin 500 mg IV piggyback every 6 hours

Place peripheral IV

Change turban dressing by cleansing with sterile water, patting dry, applying dry gauze over incision, and wrapping head with kerlix

Strict intake and output

Clear liquid diet

Answer and Explanation

The Correct Answer is ["B","C","E"]

A. Acetaminophen 600 mg PO every 6 hours PRN for pain or temperature greater than 100° F (37.7° C)
While acetaminophen is necessary for managing fever or pain, it is a PRN medication, meaning it is only given based on specific symptoms (temperature greater than 100°F or pain). Immediate administration is not required unless the client’s symptoms meet these criteria.
B. Contact precautions
Contact precautions are crucial for preventing the spread of MRSA, a highly contagious pathogen. Immediate implementation is necessary to protect both the client and others in the healthcare setting from infection.
C. Vancomycin 500 mg IV piggyback every 6 hours
Vancomycin is prescribed to treat the MRSA infection. It should be administered as ordered to manage the infection effectively and prevent complications from the surgical site infection.
D. Place peripheral IV
The peripheral IV has already been placed, as indicated by the notes. This action would have been necessary before starting the IV medication orders but is not an immediate task at this time.
E. Change turban dressing by cleansing with sterile water, patting dry, applying dry gauze over incision, and wrapping head with kerlix
Changing the turban dressing is necessary to manage the infection at the surgical site. This must be done according to the prescribed procedure to maintain sterile conditions and support healing.
F. Strict intake and output
While monitoring intake and output is important, it does not need to be done immediately but should be started as per the order to monitor the client’s fluid balance over time.
G. Clear liquid diet
Initiating a clear liquid diet is important for nutritional support, but it does not need to be started immediately. It is part of the general care plan but does not have the same urgency as infection control and medication administration

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

Explanation

A. Oxygen Concentration of the Ambient Air
The oxygen concentration of the ambient air affects how much oxygen the child could have been exposed to once retrieved from the pool. If the child was submerged in water, the ability to access oxygen from the environment was compromised, which contributes to the level of hypoxemia experienced. Ambient air oxygen concentration is a crucial factor in determining how long it might take for hypoxemia to develop or improve after submersion.
B. Temperature of Water
The temperature of the water affects the child’s physiology during submersion. Cold water can lead to a more rapid decrease in core body temperature and can influence the child’s respiratory and cardiovascular responses, potentially affecting the degree of hypoxemia.
C. The Weight of the Child
The weight of the child does not significantly impact the level of hypoxemia experienced during submersion. While it might influence the child’s ability to stay afloat or the rescue process, it does not directly affect hypoxemia levels.
D. The Amount of Time the Child Was Submerged
The duration of submersion is a critical factor in determining the level of hypoxemia. Longer submersion times result in more significant oxygen deprivation and a greater degree of hypoxemia, which can impact the severity of respiratory and cardiac complications.
E. Whether or Not Anyone Witnessed the Fall into the Pool
While witnessing the fall might be relevant for understanding the context of the incident, it does not directly affect the level of hypoxemia experienced during the submersion. The key factors are related to the conditions and duration of the submersion itself

A. Rayon. B. Polyester. C. Cotton. D. Silk.

Correct Answer is C

Explanation

A. Rayon can be irritating and is not as breathable as cotton, which can exacerbate eczema symptoms.
B. Polyester is synthetic and may irritate sensitive skin, potentially worsening eczema symptoms.
C. Cotton is recommended because it is soft, breathable, and less likely to irritate the skin, making it the most comfortable option for a child with eczema.
D. Silk can be irritating for sensitive skin and might not be as comfortable or breathable as cotton for a child with eczema.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits What factors are important in determining level of hypoxemia that the child may have experienced during the submersion? Select all that apply.

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

Explanation

The mother of a young child with eczema asks about the type of clothing that is best for her child's comfort. Which choice should the practical nurse (PN) recommend?

Correct Answer is C

Explanation

An older adult client who had a colon resection 8 days ago is straining at stool. The practical nurse (PN) observes sudden spillage of serosanguinous drainage from the client's wound followed by appearance of bowel on the skin. Which complication has occurred?

Exhibits Based on the current focused assessment, what prescriptions should the practical nurse (PN) ask the health care provider to add? Select all that apply.

A female client who has been taking oral contraceptives for the past year comes into the clinic for an annual exam. Which finding is most important for the practical nurse (PN) to report to the healthcare provider?

In which client situation should the practical nurse assess for the presence of Cheyne-Stokes respirations?

The practical nurse (PN) observes an unlicensed assistive personnel (UAP) bathing a bedfast client with the bed in the high position. Which action should the PN take?

The spouse of a hospitalized client asks the practical nurse (PN) for acetaminophen for a tension headache. Which action should the PN take?