A nurse is caring for a female client. The following diagnostic results have been recorded over two weeks:

Exhibits

Complete the following sentence by using the lists of options. The client is at risk for
dropdown
as evidenced by the
dropdown
.

Answer and Explanation

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

The client is at risk for Bleeding as evidenced by the Decrease in Platelet count from 350,000/mm² to 100,000/mm².

Rationale for Bleeding: Platelets are a crucial component of the blood that helps in clotting and preventing excessive bleeding. A decrease in platelet count from 350,000/mm² to 100,000/mm² is significant and puts the client at risk for bleeding. This is because when platelet levels fall below the normal range (150,000 to 400,000/mm²), the body’s ability to form clots and stop bleeding is compromised.

Rationale for Anemia: The client’s Hemoglobin level has decreased from 15 g/dL to 12 g/dL, which is at the lower end of the normal range (12 to 16 g/dL). However, it is still within the normal range, so the client is not currently at risk for anemia.

Rationale for Infections: The client’s White Blood Cell (WBC) count has decreased from 8,000/mm² to 6,000/mm², but it is still within the normal range (5,000 to 10,000/mm²). Therefore, the client is not currently at risk for infections.

Rationale for Cardiac arrhythmias: The client’s Potassium level has slightly decreased from 3.7 mEq/L to 3.6 mEq/L, but it is still within the normal range (3.5 to 5 mEq/L). Therefore, the client is not currently at risk for cardiac arrhythmias.

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Correct Answer is A

Explanation

Infiltration of an IV site is characterized by skin blanching, which is a whitening or lightening of the skin. This occurs when IV fluids or medications leak into the surrounding tissue from the vein. The area may also be cool to touch and swollen.

A. Regularly inspect the cord for frays or tears. B. Keep the unit at least 1.2 m (4 ft) away from a gas stove. C. Consider purchasing a generator for power backup. D. Monitor for signs of hypoxia. E. Choose synthetic clothing and bedding.

Correct Answer is ["A","B","C","D"]

Explanation

Choice A rationale

Regular inspection of the cord for frays or tears is crucial to ensure the safe operation of the home oxygen concentrator. A damaged cord can pose a risk of electric shock or fire.

Choice B rationale

Keeping the unit at least 1.2 m (4 ft) away from a gas stove is important because oxygen supports combustion. An oxygen-rich environment can cause materials to ignite more easily and make fires burn at a faster rate.

Choice C rationale

Considering the purchase of a generator for power backup is a good idea. In case of a power outage, a backup power source would ensure the continuous operation of the oxygen concentrator, which is critical for patients who are dependent on supplemental oxygen.

Choice D rationale

Monitoring for signs of hypoxia is essential. Despite receiving oxygen therapy, a patient may still experience hypoxia if the oxygen flow rate is insufficient, or if there are issues with the equipment. Signs of hypoxia include shortness of breath, rapid breathing, restlessness, confusion, and cyanosis (bluish color of the skin, lips, or nails)12.

Choice E rationale

Choosing synthetic clothing and bedding is not recommended. Synthetic materials can build up static electricity, which can spark and cause a fire in an oxygen-enriched environment.

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A nurse is caring for a female client. The following diagnostic results have been recorded over two weeks: Exhibits Complete the following sentence by using the lists of options. The client is at risk for dropdown as evidenced by the dropdown.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient who is receiving fluids through a peripheral IV catheter. Which of the following observations at the IV site should the nurse identify as signs of infiltration?

Correct Answer is A

Explanation

A nurse is providing discharge instructions to a patient who has a new prescription for a home oxygen concentrator. Which of the following instructions should the nurse provide to the patient and their family? (Select all that apply.)

Correct Answer is ["A","B","C","D"]

Explanation

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A nurse is caring for a group of clients on a medical-surgical unit.In which situation does the nurse demonstrate the ethical principle of veracity?

A nurse is caring for a female client. The following diagnostic results have been recorded over two weeks:

Exhibits

Complete the following sentence by using the lists of options. The client is at risk for
dropdown
as evidenced by the
dropdown
.