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A nurse is caring for a client in the clinic.

Exhibits

The nurse anticipates which of the following orders from the provider based on the suspected diagnosis? (Select all that apply)

IV antibiotics

Urinalysis

Chest x-ray

Chest tube placement

Admit to inpatient

Airborne precautions

Draw an STI lab panel

Complete blood count

Answer and Explanation

Correct Answer : A,C,E,H

The nurse anticipates the following orders from the provider based on the suspected diagnosis:

A. IV antibiotics: To treat the suspected infection.
C. Chest x-ray: To assess the lungs for signs of infection, such as pneumonia.
E. Admit to inpatient: The client's worsening condition and need for aggressive treatment warrant hospitalization.
H. Complete blood count: To assess the client's overall health status and identify any abnormalities, such as anemia or infection.

Rationale:

B. Urinalysis: While a urinalysis can be helpful in assessing for urinary tract infections, it is not a priority in this case.
D. Chest tube placement: This is not indicated unless the client develops a pleural effusion or pneumothorax.
F. Airborne precautions: This is not necessary for the client's current condition.
G. Draw an STI lab panel: While this may be relevant for the client's overall health, it is not a priority at this time, especially given the client's acute presentation.

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Correct Answer is C

Explanation

A. Anuria, or the absence of urine output, indicates significant renal impairment and is a later sign of shock.
B. Hypotension is a classic sign of shock but occurs after compensatory mechanisms have failed.
C. An increased respiratory rate is often one of the earliest indicators of shock, as the body attempts to compensate for reduced oxygenation and tissue perfusion by increasing respiratory effort.
D. A decreased level of consciousness can occur with prolonged shock but typically presents after other compensatory mechanisms have been overwhelmed.

A. Mottled skin B. Heart rate 160/min C. Blood pressure 115/68 mmHg D. Hypokalemia

Correct Answer is C

Explanation

A. Mottled skin is more indicative of the progressive or refractory stages of shock, where perfusion to the skin is severely compromised.
B. A heart rate of 160/min indicates tachycardia, which is common in shock but is not the most characteristic finding of the compensatory stage.
C. During the compensatory stage of shock, the body attempts to maintain blood pressure and perfusion, and a blood pressure of 115/68 mmHg suggests that compensatory mechanisms are still functioning adequately.
D. Hypokalemia is not a typical finding in the compensatory stage; rather, the body may exhibit signs of hyperkalemia due to tissue breakdown and acidosis.

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A nurse is caring for a client in the clinic. Exhibits The nurse anticipates which of the following orders from the provider based on the suspected diagnosis? (Select all that apply)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is at risk for shock. Which of the following findings is the earliest indicator that this complication is developing?

Correct Answer is C

Explanation

A nurse is caring for a client who is in the compensatory stage of shock. Which of the following findings should the nurse expect?

Correct Answer is C

Explanation

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Which of the following signs is most commonly associated with respiratory alkalosis?

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A nurse is caring for a client in the clinic.

Exhibits

The nurse anticipates which of the following orders from the provider based on the suspected diagnosis? (Select all that apply)