NUR 2755 MDC4 EXAM 2
- A client with a pulmonary embolism may have which of the following interventions?
b. embolectomy
d. heparin drug therapy - An older adult client arrives in the emergency department after falling off a roof, the
nurse observes “sucking inward” of the loose chest area during inspiration and a
“puffing out” of the same during expiration. ABGs show hypoxemia and hypercarbia.
What procedure should the nurse prepare for?
b. endotracheal intubation - A nurse in a burn treatment center is caring for a client admitted with severe burns to
both lower extremities and is scheduled for an escharotomy. The client’s spouse asks
the nurse what the procedure entails. What nursing statement is appropriate?
a. Large, surgical incision will be made in the hardened dermal layer to improve
circulation. - A nurse is caring for a client who has burn injuries to his trunk. The nurse is
explaining what to expect from the prescribed hydrotherapy. which of the following
statements by the client indicates an understanding of the teaching?
a. I will be on a special shower table to enhance wound inspection and debridement. - Calculate the MAP in mmHg for a client with a blood pressure of 84/46 mmHg.
59 mmHg - Which of the following interventions is not appropriate for a client diagnosed with a
pneumothorax?
a. apply wet to dry dressing on wound. - A client in intensive care unit was recovering from moderate burns and smoke
inhalation. His condition was improving and plans were made to transfer him to a step
down unit. On the morning of his transfer the client began to experience elevated temp
and SOB. Urine output decreased to 10ml/hr labs were drawn and indicated elevated
WBC, GFR, creatine and liver enzymes. the client is experiencing which medial
complication?
d. multiple organ dysfunction syndrome - A nurse is assessing a client who sustained superficial partial thickness and deep
partial thickness burns 38 hours ago. Which finding should the nurse report to the
provider?
d. ABG ph 7.31, PaCO2 37 mmHg, Hco3 31 mEq/L - A nurse is caring for a client who has sustained burns over 3ft of total body surface
area. The client’s voice has become hoarse, brassy cough, and drooling. The nurse
should identify these findings as indicators that the client has which of the following?
c. inhalation injury - A nurse is assisting the provider for a client who has developed a tension
pneumothorax. Which actions should be performed first?
b. prepare for large bore needle thoracostomy - When assessing a client who has suffered a burn injury, the nurse classifies the
burn as a full thickness burn based on observing which characteristics?
b. charred skin with milky areas