A home health nurse is reviewing messages from a group of clients. Which of the following clients should the nurse contact first?
Client reports that her new colostomy stoma appears purple.
Client who has COPD and reports an oxygen saturation of 90.
Client reports feeling a vibration in his new internal arteriovenous graft for dialysis.
Mother reports that her son vomited after a dose of methylphenidate.
The Correct Answer is A
A stoma that turns dark red, purple, or even black in color can be a sign of a problem with blood supply to the stoma 1. This can be a serious issue that requires immediate medical attention.
Choice B is not the correct answer because an oxygen saturation of 90 for a client with COPD is within an acceptable range.
Choice C is not the correct answer because feeling a vibration in a new internal arteriovenous graft for dialysis is not necessarily a cause for immediate concern.
Choice D is not the correct answer because vomiting after a dose of methylphenidate may be a side effect of the medication and may not require immediate attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
According to the epidemiological triangle, the host refers to the organism that can get the disease. In this case, the school-age children are the hosts because they are the ones who can get infected with the mumps virus.
Choice A is not correct because the school is not an organism that can get infected with the mumps virus.
Choice B is not correct because the virus is the agent that causes the disease, not the host.
Choice D is not correct because the vaccine is a method of prevention, not a host.
Correct Answer is ["A","B","C"]
Explanation
The correct answers are choices A, B, and C.
Choice A rationale:
Maintaining the head of the client’s bed in an elevated position after eating can help reduce nausea by preventing gastric reflux and promoting better digestion.This position helps keep stomach contents from moving back up into the esophagus, which can trigger nausea.
Choice B rationale:
Assisting the client in using guided imagery is a beneficial non-pharmacological intervention for managing chemotherapy-induced nausea.Guided imagery involves using mental visualization techniques to create calming and positive images, which can help distract the mind from nausea and reduce its intensity.
Choice C rationale:
Providing sips of room-temperature ginger ale between meals can help alleviate nausea. Ginger has natural antiemetic properties that can help soothe the stomach and reduce nausea.Room-temperature liquids are often easier to tolerate than cold or hot beverages.
Choice D rationale:
Using seasonings to enhance the flavor of foods is not typically recommended for clients experiencing chemotherapy-induced nausea. Strong flavors and smells can sometimes exacerbate nausea rather than alleviate it.Bland, easy-to-digest foods are usually better tolerated.
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