A nurse is assessing a client who has cirrhosis.

Which of the following findings is the priority for the nurse to report?

Distended abdomen.

Clay-colored stools.

Platelets 70,000/mm.

Alkaline phosphatase 125 units/L.

Answer and Explanation

The Correct Answer is C

Platelets 70,000/mm.
The priority finding for a nurse assessing a client who has cirrhosis to report is a platelet count of 70,000/mm.
A low platelet count (thrombocytopenia) can be a complication of cirrhosis and can increase the risk of bleeding.
A platelet count below 150,000/mm3 is considered low and should be reported to the provider.
Choice A is incorrect because while a distended abdomen can be a sign of ascites, a complication of cirrhosis, it is not the priority finding to report.
Choice B is incorrect because while clay-colored stools can be a sign of biliary obstruction, it is not the priority finding to report.
Choice D is incorrect because while an elevated alkaline phosphatase level can be a sign of liver damage, it is not the priority finding to report.

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Correct Answer is C

Explanation

A saw-tooth pattern with an atrial rate of 250 to 400/min is a characteristic finding on a cardiac rhythm strip of a client who has atrial flutter.
Choice A is incorrect because progressively longer PR durations are characteristic of a Mobitz type I second-degree AV block, not atrial flutter.
Choice B is incorrect because undetectable P waves are characteristic of atrial fibrillation, not atrial flutter.
Choice D is incorrect because absent PR intervals with a ventricular rate of 40 to 60/min are characteristic of third-degree AV block, not atrial flutter.

A. Cool, clammy skin. B. Acetone breath. C. Kussmaul respirations. D. Increased urine output.

Correct Answer is A

Explanation

This statement indicates an understanding of the teaching because cool, clammy skin is a common symptom of hypoglycemia.
Choice B is incorrect because acetone breath is a symptom of hyperglycemia (high blood sugar), not hypoglycemia (low blood sugar).
Choice C is incorrect because Kussmaul respirations (deep and labored breathing) are a symptom of hyperglycemia, not hypoglycemia.
Choice D is incorrect because increased urine output is a symptom of hyperglycemia, not hypoglycemia.

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A nurse is assessing a client who has cirrhosis. Which of the following findings is the priority for the nurse to report?

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing a cardiac rhythm strip of a client who has atrial flutter. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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A nurse is assessing a client who has cirrhosis.

Which of the following findings is the priority for the nurse to report?