A nurse is assessing a client who is postoperative and has a history of pulmonary embolism. Which of the following findings is the priority for the nurse to report to the provider?

Hypotension

Tachycardia

Dyspnea

Dry cough

Answer and Explanation

The Correct Answer is C

A. Hypotension is a concern but may occur for various reasons and is not as immediately life-threatening as dyspnea.

B. Tachycardia can indicate a problem but is less urgent than respiratory distress.

C. Dyspnea is the priority as it may indicate a recurrence of pulmonary embolism or another life-threatening respiratory issue.

D. A dry cough is a less urgent symptom and does not require immediate reporting.

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Correct Answer is D

Explanation

A. "I had to retire because my boss didn't like me.": Indicates projection, attributing personal feelings to someone else.

B. "There were lay-offs at my company, so I journaled about what I accomplished during my career.": Indicates positive coping, not compensation.

C. "I'm so glad I've retired because the work was making me sick and depressed.": Indicates rationalization, justifying the situation.

D. "Since I retired, I have entered many gardening competitions.": The client is compensating for the loss of work-related identity by engaging in competitive gardening, a constructive coping strategy.

A. Administer flumazenil to the client. B. Monitor the client's IV site for thrombophlebitis. C. Initiate seizure precautions for the client. D. Evaluate the client for further suicidal behavior.

Correct Answer is A

Explanation

A. Flumazenil is the antidote for benzodiazepine overdose and should be administered to reverse the effects of diazepam.

B. Monitoring the IV site is important but not an immediate priority in this situation.

C. Seizure precautions are not the primary concern after benzodiazepine overdose.

D. Evaluating for suicidal behavior is important but comes after stabilizing the client.

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A nurse is assessing a client who is postoperative and has a history of pulmonary embolism. Which of the following findings is the priority for the nurse to report to the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing the coping strategies of a client who has recently retired. Which of the following statements by the client indicates that the client is using compensation as a defense mechanism?

Correct Answer is D

Explanation

A nurse in an emergency department is assessing a client who reports ingesting thirty diazepam tablets 20 min ago. The client is lethargic and a respiratory rate of 10/min. After securing the client's airway and initiating an IV, which of the following actions should the nurse take next?

Correct Answer is A

Explanation

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