A nurse in an emergency room is caring a the client who sustained partial-thickness burns to both lower legs, chest, face, and both forearms. Which of the following is the priority action the nurse should take?

Insert an indwelling urinary catheter.

Draw blood for a complete blood cell (CBC) count.

Inspect the mouth for signs of inhalation injuries.

Administer intravenous pain medication.

Answer and Explanation

The Correct Answer is C

This is because inhalation injuries can compromise the airway and cause respiratory distress or failure, which can be life-threatening. The nurse should assess for signs such as soot, burns, hoarseness, or stridor.

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Correct Answer is B

Explanation

This is because older adults may not have typical signs and symptoms of pneumonia, such as fever, cough, and chest pain. Instead, they may present with confusion, lethargy, or delirium due to hypoxia or dehydration.

A. The client has an increased risk of infection. B. The client should receive a diet with increased protein. C. The client has an increased risk for bleeding. D. The client should receive an erythropoiesis stimulating agent.

Correct Answer is ["A","C"]

Explanation

Answer: A. The client has an increased risk of infection.

Rationale: This is because the client's white blood cell (WBC) count is low, which indicates a compromised immune system. The normal range for WBC is 4,000 to 11,000/mm3. A low WBC count can be caused by chemotherapy, which is a common treatment for ovarian cancer. The nurse should monitor the client for signs of infection, such as fever, chills, redness, swelling, or drainage, and implement infection prevention measures, such as hand hygiene, sterile technique, and isolation precautions.

Answer: C. The client has an increased risk for bleeding.

Rationale: This is because the client's platelet count is low, which indicates a reduced ability to form clots and stop bleeding. The normal range for platelets is 150,000 to 400,000/mm3. A low platelet count can be caused by chemotherapy, which can damage the bone marrow where platelets are produced. The nurse should monitor the client for signs of bleeding, such as petechiae, ecchymosis, hematuria, or melena, and implement bleeding prevention measures, such as avoiding invasive procedures, applying pressure to puncture sites, and using soft-bristled toothbrushes.

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A nurse in an emergency room is caring a the client who sustained partial-thickness burns to both lower legs, chest, face, and both forearms. Which of the following is the priority action the nurse should take?

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Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is assessing an older adult client whose son reports that the client has been sick with a respiratory illness for the past 6 days. Which of the following assessment findings is a manifestation of pneumonia in the older adult client?

Correct Answer is B

Explanation

Correct Answer is ["A","C"]

Explanation

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