ATI physiological adaptation Quiz

ATI physiological adaptation Quiz ScienceMedicineNursing Brianna_Still84 Save

NCLEX EXAM PREVIEW

110 terms kandykat1012Preview ATI comprehensive predictor STUDY...198 terms h_trtPreview

ATI REDUCTION OF RISK POTENTI...

66 terms shelby__chinen Preview PEARS 199 term Can A nurse is caring for a client diagnosed with diabetes. The nurse notes that the client has a mild trimmer, slight diaphoresis and is fully oriented.Which of the following nursing action should have the highest priority?Assess the clients blood glucose level A client is admitted to the surgical unit after sustaining a compound fracture of the left femur. The client is alert and oriented with the following vital signs: T 99.4°F, HR 88, RR 20, BP 94/58. The nurse notes a 4 cm area of bright red blood on the pressure dressing on the lower left extremity.The client is receiving intravenous fluids of normal saline at 150 mL/hr. One hour after being admitted to the Unit in the, Nurse, find the client confused and combative. Which of the following is most likely cause of the change in the clients condition?Hypoxia related to fat embolism from the fractured bones A nurse is caring for a client on the telemetry unit who is two days post coronary artery bypass grafting. The nurse recognizes a cardiac rhythm.Change from normal sinus rhythm to atrial fibrillation. Which of the following findings should be completed first?Assess the clients blood pressure The nurse is planning care for a client who has prescribed antiembolic stockings following abdominal surgery which of the following intervention should the nurse include?Remove stockings one to three times per day for skin care and inspection A nurse is teaching lifestyle modifications to a client diagnosed with hypertension. Which of the following statements made by the client indicates a need for further teaching?I will substitute mushrooms for the bacon in my daily omelettes

A nurse is caring for a client who is experiencing a sodium level of 119 mEq/L. Which nursing action would be most appropriate at this time?Administer 0.9% Normal Saline.A nurse is caring for a client with diabetes insipidus who has been prescribed aqueous vasopressin. Which of the following outcomes indicates that treatment has been effective.?Fluid intake of 2.4 L in 24 hours.Which of the following should the nurse use to determine the neurological status of a client with a head injury?The Glasgow coma scale A client is admitted to the medical unit from the convalescent center for treatment of urosepsis. The clients adult daughter reports to the nurse, "I don't know what to do. I love my mom and would like to have her live in my home but I can't be with her every minute and that's what she needs right now." Which of the following would be the best approach to improve integration of the elderly mother into the family structure?Determine if the daughter would consider having the client visit in her home one day a week A nurse is reviewing a clients lab results, which finding would leave the nurse to suspect the client is experiencing dehydration?Hematocrit 55% A nurse is caring for a toddler who is being treated for hypovolemia. Which of the following demonstrates to the nurse the desired response to fluid replacement?Specific Gravity 1.025 CorrectSpecific gravity falls within normal range of 1.010-1.030 and indicates successful fluid replacement.A nurse is caring for a client recovering from an abdominal, aortic aneurysm repair. Which of the following findings would have the highest priority?Blood pressure 136/90 A nurse is caring for a client recently diagnosed with diabetes mellitus. Which of the following is the physiological basis for the polyuria manifestation by individuals with untreated diabetes mellitus?Hyper osmolarity of the extra cellular fluid secondary to hyperglycemia A client diagnosed with atrial fibrillation, has a pacemaker sit at a ventricular rate of 70 bpm. Which of the following findings should the nurse immediately report to the provider?Heart rate 60 bpm and regular A client with chronic obstructive pulmonary disease has oxygen therapy ordered. Which principalship guide the nurse in managing the delivery of oxygen to this client.?Clients with COPD should receive low concentrations(2-3L/min) of oxygen since the stimulus to breed is there low PaO2

A nurse is caring for a client who is intubated and receiving ventilatory assistance. The high-pressure alarm is sounding on the ventilator. Which of the following would have the highest priority?Assess the clients need for suctioning.One hour ago a nurse administered morphine sulfate, 4 mg IV. Push to a client who reported pain of nine on a scale of 10. The client now reports pain of a seven on a scale of 10. What is the priority intervention at this time?Notify the provider of clients report A client has undergone and a oral femoral bypass for the treatment of peripheral artery disease. Which of the following finding should be reported to the surgeon immediately.?Systolic blood pressure 160 A client is prescribed warfarin daily. Which of the following statement made by the client indicates to the nurse I need for further teaching.?I have been eating more salads and other green leafy vegetables to prevent constipation A client comes to the emergency department reporting epistaxis. Which of the following medication should the nurse expect as contributing to the epistaxes?Ibuprofen A client is admitted to the hospital for treatment of an acute asthma attack. The client is receiving an amino filing infusion. Which of the following assessment findings indicates the client is experiencing the desired effect of aminophylline.Decreased wheezing A nurse is caring for a client who had a gastric resection to treat peptic ulcer disease. What is the priority intervention when caring for the client in the immediate postoperative period.Assess NG tube for patency A client presents to the emergency department with an abdominal stab wound. The nurse visualizes intestines protruding through the wound.Which of the following is an appropriate action for the nurse?Cover wound with warm saline-soaked gauze A nurse is caring for a client who has reported difficulty sleeping. Which statement made by the client requires further assessment?I have been really stressed out at work lately A nurse is caring for a client with a partial hearing impairment. The nurse understands which of the following is the best way to communicate with this client?Speak slowly in a low, pitched voice

A client is admitted to the emergency room after falling outside his home. The client is complaining of a severe headache with pain above his left eye. The client is restless and intermittently, loses consciousness. Pupils are dilated pulse 56 blood pressure 168/98 an x-ray of the head confirms a skull fracture. Which of the following is a priority assessment Respiratory status A nurse is caring for a client following a spinal cord injury. Which of the following findings would alert the nurse to the development of neurogenic shock?Hypotension During a home visit a ten-day postpartum client reports pain and tenderness with redness and swelling to her right breast. A localized hard mass is also noted upon palpation. How should the nurse respond to this client?The symptoms suggest an inflammatory or infectious process and require immediate notification to your healthcare provider A nurse is caring for a client who has just undergone a bone marrow transplant. Neutropenic precautions are implemented to prevent infection.Which of the following is not a precautionary neutropenic measure?Monitor platelets Terms (29) Hide definitions