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A nurse is preparing to administer medications to four clients. The nurse should administer medications to which of the following clients first?

A client who is post-coronary artery bypass graft (CABG), has total cholesterol of 318 mg/dL, and is prescribed atorvastatin

A client who has pneumonia, a WBC count of 11,500/mm³, and is prescribed piperacillin

A client who has renal failure, a serum potassium of 5.8 mEq/L, and is prescribed sodium polystyrene sulfonate

A client who has anemia, hemoglobin of 11 g/dL, and is prescribed epoetin alfa

Answer and Explanation

The Correct Answer is C

Choice A Reason: This is incorrect because a client who is post-CABG and has high cholesterol is not in immediate danger, as atorvastatin is a long-term medication that lowers cholesterol and prevents cardiovascular complications.

Choice B Reason: This is incorrect because a client who has pneumonia and a slightly elevated WBC count is not in immediate danger, as piperacillin is an antibiotic that treats bacterial infections.

Choice C Reason: This is correct because a client who has renal failure and a high serum potassium level is in immediate danger, as sodium polystyrene sulfonate is an emergency medication that lowers potassium and prevents cardiac arrhythmias.

Choice D Reason: This is incorrect because a client who has anemia and a mild hemoglobin deficiency is not in immediate danger, as epoetin alfa is a long-term medication that stimulates red blood cell production and improves oxygen delivery.

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Correct Answer is B

Explanation

Choice A Reason: Urine output is not a finding that should decrease with adequate ﬂuid replacement. On the contrary, urine output should increase as the ﬂuid therapy restores the renal perfusion and function. The nurse should monitor the urine output and ensure that it is at least 0.5 mL/kg/hr for adults and 1 mL/kg/hr for children.

Choice B Reason: Heart rate is a finding that should decrease with adequate ﬂuid replacement. A high heart rate is a sign of hypovolemia, which occurs when the burn injury causes ﬂuid loss from the intravascular space. The nurse should monitor the heart rate and expect it to decrease as the ﬂuid therapy replenishes the blood volume and improves the cardiac output.

Choice C Reason: Weight is not a finding that should decrease with adequate ﬂuid replacement. On the contrary, weight may increase as the ﬂuid therapy restores the hydration status and corrects the ﬂuid deficit. The nurse should monitor the weight and compare it with the pre-burn weight to evaluate the ﬂuid balance.

Choice D Reason: Blood pressure is not a finding that should decrease with adequate ﬂuid replacement. On the contrary, blood pressure may increase as the ﬂuid therapy restores the vascular tone and improves the tissue perfusion. The nurse should monitor the blood pressure and expect it to increase as the ﬂuid therapy compensates for the ﬂuid loss.

A. Equal amount of ﬂuid drainage in each collection chamber B. Fluctuation of the ﬂuid level within the water seal chamber C. Continuous bubbling within the water seal chamber D. Absence of ﬂuid in the drainage tubing

Correct Answer is B

Explanation

Choice A Reason: Equal amount of ﬂuid drainage in each collection chamber is not a sign of proper chest tube function. The amount of ﬂuid drainage depends on the type and extent of the client's injury or surgery, and may vary from one chamber to another.

Choice B Reason:Fluctuation of the fluid level in the water seal chamber(tidaling) indicates that the chest tube is functioning properly. This fluctuation corresponds with the client's respirations and shows that air or fluid is being effectively removed from the pleural space.

Choice C Reason:Continuous bubbling within the water seal chamber: Continuous bubbling in the water seal chamber indicates an air leak, which is not normal unless the client has a pneumothorax and air is being evacuated. Otherwise, it suggests a problem with the system.

Choice D Reason: Absence of ﬂuid in the drainage tubing is not a sign of proper chest tube function. It may indicate that the chest tube is obstructed, kinked, or clamped, or that the suction is not working properly. The nurse should assess and troubleshoot the chest tube system.

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A nurse is preparing to administer medications to four clients. The nurse should administer medications to which of the following clients first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is monitoring a client who was admited with a severe burn injury and is receiving IV ﬂuid resuscitation therapy. The nurse should identify a decrease in which of the following findings as an indication of adequate ﬂuid replacement?

Correct Answer is B

Explanation

The nurse is caring for a postoperative client who has a chest tube connected to suction and a water seal drainage system. Which of the following indicates to the nurse that the chest tube is functioning properly?

Correct Answer is B

Explanation

A nurse is reviewing the arterial blood gas values for a client. The pH is 7.32, PaCO2 is 48 mm Hg and the HCO3 is 23 mEq/L. The nurse should recognize that these findings indicate which of the following acid-base imbalances?

A nurse in the emergency department is caring for a client who has extensive partial and full-thickness burns of the head, neck, and chest. While planning the client's care, the nurse should identify which of the following risks as the priority for assessment and intervention?

A nurse is assessing a client who has a pneumothorax with a chest tube in place. For which of the following findings should the nurse notify the provider?

A nurse in an emergency department is caring for an adult client who has burns on the front and back of both his legs and arms. Using the rule of nines, the nurse should document burns to which percentage of the client's total body surface area (TBSA)?

A nurse in the ICU is caring for a client who has heart failure and is receiving a dobutamine drip. The nurse should identify that which of the following findings indicates that the medication is eﬀective?

The nurse in a trauma unit has received a report on a client who has multiple injuries following a motor vehicle crash. Which of the following actions should the nurse plan to take first?

A nurse in an emergency department is caring for a client who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. The nurse should anticipate which of the following prescriptions from the provider?