A nurse in the medical-surgical unit is assigning client care to a nurse who is floating from the PACU. The nurse should recognize that the float nurse is most qualified to care for which of the following clients?

A client who is being discharged to a long-term care facility

A client who is postoperative following a lobectomy and has a chest tube

A client who needs teaching about insulin self-administration

A client who needs teaching prior to initiating cardiac rehabilitation activities

Answer and Explanation

The Correct Answer is B

A. A client being discharged to a long-term care facility may need comprehensive discharge planning, which involves familiarity with long-term care requirements, but this is not typically within the primary expertise of a PACU nurse.
B. A client who is postoperative following a lobectomy and has a chest tube falls within the PACU nurse's area of expertise. PACU nurses are experienced in monitoring and managing postoperative clients, including those with chest tubes, as these clients require close monitoring for complications such as respiratory distress or chest tube malfunction.
C. Teaching about insulin self-administration is important, but this task is more suited to nurses experienced in chronic care management, such as those from medical-surgical or endocrinology units.
D. Teaching prior to initiating cardiac rehabilitation requires specialized knowledge in cardiac care, which may not be the primary focus of a PACU nurse's practice.

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Correct Answer is B

Explanation

A. Monitoring urine output is not specifically related to the side effects of ethambutol.
B. Ethambutol can cause optic neuritis, so monitoring visual acuity is essential.
C. Skin color changes are not commonly associated with ethambutol therapy.
D. Cardiac rhythm monitoring is not necessary for clients on ethambutol.

A. A client who had a hemi-colectomy and placement of a colostomy B. A client who has a chest tube following a fall from a ladder C. A client receiving continuous enteral feeding through NG tube D. A client who Crohn's disease and has an ileostomy

Correct Answer is C

Explanation

A. A client with a hemi-colectomy and colostomy is not at highest risk for aspiration.
B. A client with a chest tube may have respiratory issues but is not at the highest risk for aspiration.
C. A client receiving continuous enteral feeding through an NG tube is at the highest risk for aspiration due to the risk of feeding contents entering the airway.
D. A client with Crohn's disease and an ileostomy is not at the highest risk for aspiration.

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A nurse in the medical-surgical unit is assigning client care to a nurse who is floating from the PACU. The nurse should recognize that the float nurse is most qualified to care for which of the following clients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is hospitalized with active pulmonary tuberculosis and is started on ethambutol therapy. The nurse should understand that which of the following should be monitored?

Correct Answer is B

Explanation

A nurse is caring for four clients. Which of the following clients should the nurse identify as having the highest risk for aspiration?

Correct Answer is C

Explanation

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