Which patient should the nurse assess first after receiving a change-of-shift report?
A patient with a scheduled physical therapy session in 1 hour.
A patient with a routine follow-up appointment for a non-urgent condition.
A patient with altered mental status and confusion.
A patient with moderate pleuritis and requesting pain medication.
The Correct Answer is C
A. While this patient is scheduled for a physical therapy session, it is not an urgent concern that would require immediate attention.
B. A routine follow-up appointment for a non-urgent condition can be managed at a later time and does not take priority over more acute concerns.
C. A patient with altered mental status and confusion should be assessed first. This could indicate a serious underlying issue such as infection, hypoxia, or a neurological condition. Altered mental status in any patient warrants immediate attention to prevent further complications.
D. Although the patient with pleuritis is in pain, moderate pleuritis is typically not an urgent condition, and pain management can be provided after more pressing concerns are addressed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["0.4"]
Explanation
Volume (mL) = Desired dose (mg) / Concentration (mg/mL)
In this case:
- Desired dose = 35 mg
- Concentration = 75 mg/mL
Plugging the values into the formula:
- Volume = 35 mg / 75 mg/mL = 0.4 mL
Correct Answer is C
Explanation
A. Administering a broad-spectrum antibiotic is not the first action in this case. The first priority is to assess the situation and obtain a culture of the drainage to identify any infection before initiating antibiotics.
B. While notifying the healthcare provider is important, it is more important to take an initial action by obtaining a culture specimen. Waiting without taking action could delay appropriate care.
C. The best first action is to obtain a culture of the drainage to identify any potential infection, apply a sterile dressing, and continue to monitor the site for further signs of infection. Culturing the drainage helps guide the appropriate treatment.
D. Removing the sutures is not the appropriate action. The sutures should not be removed unless there is clear indication, as this could disrupt the integrity of the catheter placement.
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