A nurse is caring for a 65-year-old male client in the emergency department. The client is presenting with symptoms of a potential cardiac event and has been admitted for further evaluation.
Complete the following sentence by selecting the most appropriate actions based on the client’s current status.
The nurse should first
The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}
The nurse should first: Response 1: Notify the primary health care provider immediately.
This is crucial because the client is showing signs of a potential cardiac event, which requires immediate medical attention.
Then, the nurse should: Response 2: Start an IV line for potential medication administration.
Starting an IV line ensures that the client can receive any necessary medications quickly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Turning the client on their back during seizures is not recommended as it can obstruct the airway and increase the risk of injury. Positioning on the side is safer to maintain an open airway.
Choice B rationale
Gently restraining the client during seizures can cause injury and is not advisable. It is important to protect the client from harm by clearing the area around them instead.
Choice C rationale
Loosening the client’s clothing during seizures can help ensure they are not restricted and can breathe comfortably. It also reduces the risk of injury from tight or constrictive clothing.
Choice D rationale
Inserting a washcloth or any object into the client’s mouth during seizures is dangerous and can cause choking or damage to the teeth and mouth. The focus should be on ensuring safety without putting objects in the mouth.
Correct Answer is D
Explanation
Choice A rationale
Drinking citrus juice with meals can irritate the bladder and exacerbate urinary incontinence due to the high acidity in citrus fruits. It is not recommended for individuals with urinary incontinence.
Choice B rationale
Training the bladder by voiding every 5 hours is too infrequent for most individuals. Bladder training usually involves more frequent voiding intervals to gradually increase the bladder's capacity to hold urine.
Choice C rationale
Applying adult diapers at bedtime can be useful in managing nighttime incontinence but does not address the underlying issue or provide a long-term solution for urinary incontinence.
Choice D rationale
Performing pelvic-muscle exercises, also known as Kegel exercises, can strengthen the pelvic floor muscles and improve bladder control, making it an effective method for managing urinary incontinence.
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