A charge nurse on a medical-surgical unit is anticipating an emergency response plan following an external disaster in the community. Which of the following current clients should the nurse recommend for early discharge?

A client who has cancer and a sealed radiation implant.

A client who has COPD and a respiratory rate of 24 breaths/min.

A client who is receiving heparin for deep vein thrombosis.

A client who is 1 day postoperative following a cholecystectomy.

Answer and Explanation

The Correct Answer is D

Choice A reason: A client with a sealed radiation implant requires strict precautions and monitoring to prevent radiation exposure to others. Early discharge is unsafe due to ongoing treatment needs, so this client is not suitable, making this incorrect.
Choice B reason: A COPD client with a respiratory rate of 24 breaths/min indicates potential instability, requiring monitoring for exacerbation. Early discharge risks decompensation without ensured stability, so this client is not appropriate, making this incorrect.
Choice C reason: A client receiving heparin for DVT needs continuous anticoagulation and monitoring to prevent embolism. Discharging early risks clotting complications, so this client requires ongoing hospital care, making this incorrect for early discharge.
Choice D reason: A client 1 day post-cholecystectomy, if stable, is often ready for discharge, as this surgery is routine with quick recovery. Freeing this bed supports disaster response, aligning with triage principles, making this the correct choice.

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Correct Answer is C

Explanation

Choice A reason: Starting work in a parking garage while on warfarin does not inherently indicate a need for referral unless specific risks (e.g., injury prone to bleeding) are present. Without additional concerns, this situation is routine, making it incorrect for requiring further care.
Choice B reason: Increased urinary frequency with bumetanide, a diuretic, is an expected side effect, not requiring referral unless severe or accompanied by electrolyte imbalances. This is a normal response, so it does not warrant further care, making it incorrect.
Choice C reason: An induration 48 hours after a Mantoux test suggests a positive tuberculosis result, requiring referral for chest X-ray and further evaluation. This finding indicates potential latent or active TB, a significant health concern, making it the correct choice for referral.
Choice D reason: Being 1 day postoperative after knee replacement is expected, with routine monitoring for complications like infection or thrombosis. Without specific issues, this does not require referral beyond standard postoperative care, making it incorrect.

A. Dehydration is associated with gastroesophageal reflux. B. Dehydration is caused by decreased hemoglobin and hematocrit. C. Dehydration can increase the risk for preterm labor. D. Dehydration is treated with calcium supplements.

Correct Answer is C

Explanation

Choice A reason: Dehydration is not directly associated with gastroesophageal reflux, which involves gastric acid backflow. Dehydration affects fluid balance, not reflux mechanisms, so this statement is inaccurate and irrelevant to preterm contractions, making it incorrect.
Choice B reason: Dehydration is not caused by decreased hemoglobin and hematocrit; rather, it may elevate these due to hemoconcentration. This statement reverses the relationship, making it factually incorrect and unrelated to preterm labor risks.
Choice C reason: Dehydration can increase preterm labor risk by reducing uterine blood flow and triggering contractions via oxytocin release. This evidence-based link supports hydration as a preventive measure, making it the correct statement for teaching in this scenario.
Choice D reason: Dehydration is treated with fluid replacement, not calcium supplements, which address bone health or specific deficiencies. This treatment is irrelevant to dehydration or preterm labor, making it an incorrect and inappropriate recommendation.

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A charge nurse on a medical-surgical unit is anticipating an emergency response plan following an external disaster in the community. Which of the following current clients should the nurse recommend for early discharge?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing teaching to a client who has a new prescription for warfarin. Which of the following findings requires a referral for further care?

Correct Answer is C

Explanation

A nurse is providing teaching to a client who is experiencing preterm contractions and dehydration. Which of the following statements should the nurse make?

Correct Answer is C

Explanation

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