A nurse is caring for a client who was recently admitted and has symptomatic bradycardia.

Exhibits

The nurse is caring for the client immediately following the insertion of the permanent pacemaker.

Complete the following sentence by using the list of options.

The nurse should monitor the client for
dropdown
and
dropdown
following permanent pacemaker placement.

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

Incisional Site Bleeding: This is important to check as it indicates possible complications like infection or hematoma formation at the pacemaker insertion site.
Bradycardia: It is essential to ensure that the pacemaker is functioning correctly and managing bradycardia as intended. Continuous monitoring is needed to detect any issues related to pacemaker settings or lead placements.

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Correct Answer is C

Explanation

A. Measuring the circumference of the thigh can help assess for swelling but is not specific for neurovascular assessment.
B. Palpating the femoral pulse is not as relevant for assessing neurovascular status at the site of a femur fracture; instead, the focus is on more distal pulses and sensations.
C. Instructing the client to wiggle his toes assesses motor function and circulation to the distal extremities, which are crucial for neurovascular status.
D. Monitoring the calf for edema is not the primary method for assessing neurovascular status at the site of a femur fracture; it’s more relevant for assessing for deep vein thrombosis.

A. Tachypnea B. Bilateral weakness of extremities C. Decreased level of consciousness D. Hypotension

Correct Answer is C

Explanation

A. Tachypnea is not a primary sign of increased intracranial pressure but might be seen in other conditions.

B. Bilateral weakness of extremities can indicate severe brain injury but is not the most specific sign of increased intracranial pressure.

C. Decreased level of consciousness is a direct sign of increased intracranial pressure affecting brain function.

D. Hypotension is not a typical manifestation of increased intracranial pressure; increased ICP more commonly leads to hypertension.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has an unrepaired femur fracture of the midshaft. Which of the following techniques should the nurse use when performing an assessment of the client's neurovascular status?

Correct Answer is C

Explanation

A nurse is caring for a client who has sustained a traumatic brain injury. The nurse should monitor the client for which of the following manifestations of increased intracranial pressure?

Correct Answer is C

Explanation

A nurse is assessing a client who has ataxia. Which of the following actions should the nurse take to evaluate the client's ability to safely ambulate?

The healthcare provider prescribes regular insulin 8 units/hr intravenously (IV). The IV solution contains 100 units of regular insulin in 100 mL of 0.9% normal saline. How many mL/hr should the nurse program the infusion pump? (Enter numerical value only.)

A nurse is assessing a client who has a long history of smoking and is suspected of having laryngeal cancer. The nurse should anticipate that the client will report that her earliest manifestation was

A nurse is caring for a client who reports heart palpitations. An ECG confirms the client is experiencing ventricular tachycardia (VT). The nurse should anticipate the need for taking which of the following actions?

A nurse is teaching a client who is receiving treatment for metastatic colorectal cancer about the adverse effects of bevacizumab. The nurse should instruct the client to report which of the following findings as an adverse effect of the medication?

A nurse is shopping and finds a woman who has collapsed with right-sided weakness and slurred speech. Which of the following actions should the nurse take?

A nurse is caring for a client who has fractures of the symphysis pubis and pelvis. The nurse should monitor the client for which of the following findings of a common complication of pelvic fractures?

A nurse is planning care for a client who is postoperative following a total hip arthroplasty. Which of the following interventions should the nurse include in the plan of care?