A client who fell and broke a wrist is admitted for 24-hour observation after emergency orthopedic surgery. The healthcare provider prescribes discharge in the morning. Which finding(s) should the nurse use to evaluate the client's status for discharge from the hospital? Select all that apply.

Oral medications, including analgesics, are tolerated without vomiting.

Vital signs within normal limits and blood pressure of 142/94 mm Hg.

Pain rating of 5 on a 0 to 10 scale and taking oral analgesics every 4 hours.

Client is able to ambulate to the bathroom safely to void.

Bowel sounds are present in all four quadrants and abdomen is soft.

Answer and Explanation

Correct Answer : A,D

Choice A reason: Tolerating oral medications without vomiting is essential for discharge to ensure the client can manage pain and take necessary medications at home.

Choice B reason: While vital signs are important, the slightly elevated blood pressure alone may not prevent discharge if other criteria are met.

Choice C reason: A pain rating of 5 managed with oral analgesics is acceptable for discharge if the client can manage pain at home.

Choice D reason: Being able to ambulate to the bathroom safely is crucial for discharge to ensure the client can independently manage basic needs.

Choice E reason: Bowel sounds and a soft abdomen are important but are not the primary criteria for discharge in this context.

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Correct Answer is D

Explanation

Choice A reason: A listing of African-American women in the community may help identify the target audience but is not as crucial as engaging the community leaders.

Choice B reason: Morbidity data for breast cancer in women of all races provides background information but does not directly address the specific needs of African-American women.

Choice C reason: Technical assistance to produce a video is useful but secondary to involving the community in the planning process.

Choice D reason: Participation of community leaders is vital as they can provide insights into cultural and social factors that influence health behaviors, ensuring the program is culturally relevant and effective.

A. Monitor daily sodium intake. B. Measure ankle circumference. C. Obtain serum creatinine levels daily. D. Ensure client takes a diuretic every morning.

Correct Answer is A

Explanation

Choice A reason: Monitoring daily sodium intake is crucial because SIADH often leads to hyponatremia (low sodium levels). Keeping track of sodium intake helps manage and prevent complications associated with sodium imbalances, such as seizures or confusion.

Choice B reason: Measuring ankle circumference can help assess fluid retention, but it is not the first intervention. It is more important to address the underlying issue of sodium imbalance.

Choice C reason: Obtaining serum creatinine levels daily can provide information about kidney function but does not directly address the immediate concern of sodium and fluid balance in SIADH.

Choice D reason: Ensuring the client takes a diuretic every morning may be part of the treatment plan, but it is more important to first monitor and manage sodium levels to ensure safe and effective use of diuretics.

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A client who fell and broke a wrist is admitted for 24-hour observation after emergency orthopedic surgery. The healthcare provider prescribes discharge in the morning. Which finding(s) should the nurse use to evaluate the client's status for discharge from the hospital? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse has received funding to design a health promotion project for African-American women who are at risk for developing breast cancer. Which resource is most important in designing this program?

Correct Answer is D

Explanation

A client is being treated for syndrome of inappropriate antidiuretic hormone (SIADH). On examination, the client has a weight gain of 4.4 lbs (2 kg) in 24 hours and an elevated blood pressure. Which intervention should the nurse implement first?

Correct Answer is A

Explanation

The nurse is working on an infectious disease unit. Which client should be assigned to a room with negative airflow, while requiring personnel to use a particulate respirator mask, and requiring staff to observe airborne, as well as standard precautions?

A client who fell and broke a wrist is admitted for 24-hour observation after emergency orthopedic surgery. The healthcare provider prescribes discharge in the morning. Which finding(s) should the nurse use to evaluate the client's status for discharge from the hospital? Select all that apply.

The nurse is developing a plan of care for an older male client with type 2 diabetes who reports blurred vision. Which outcome should the nurse include in the plan of care for this client?

A client is admitted to the intensive care unit (ICU) with a spinal cord injury following a motor vehicle collision. Which nurse should be contacted to coordinate the progression of the client's care?

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Which assessment technique provides the most useful data when the nurse is concerned about possible urinary retention?

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