A nurse is receiving change-of-shift report for a group of clients. Which of the following clients should the nurse plan to assess first?
A client who has sinus arrhythmia and is receiving cardiac monitoring.
A client who has a hip fracture and a new onset of tachypnea.
A client who has epidural analgesia and weakness in the lower extremities.
A client who has diabetes mellitus and an HbA1c of 7.2% (less than 7%).
The Correct Answer is B
A. Sinus arrhythmia is a benign condition that does not typically require immediate assessment unless accompanied by other concerning symptoms.
B. Tachypnea in a client with a hip fracture may indicate a potential complication such as pulmonary embolism or respiratory compromise, requiring immediate assessment and intervention.
C. While weakness in the lower extremities in a client with epidural analgesia warrants assessment, it is not as urgent as assessing a client with new-onset tachypnea.
D. An HbA1c level of 7.2% in a client with diabetes mellitus, while slightly above the target range, does not require immediate assessment or intervention unless accompanied by acute symptoms of hyperglycemia.
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Related Questions
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"A"}}
Explanation
Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"},"G":{"answers":"A"}}
Explanation
A. Airborne precautions are appropriate for TB. Not contact.
B. Ethambutol is one of the first-line medications used in the treatment of tuberculosis (TB). It works by inhibiting the growth of TB bacteria, thereby helping to eliminate the infection.
C. A monthly TB skin test is not a standard part of treatment for a patient with active TB and is therefore contraindicated.
D. Isoniazid is another first-line medication used in the treatment of TB. It works by killing the TB bacteria and is often used in combination with other medications to treat active TB infection.
E. Since the sputum culture is positive for M. tuberculosis, airborne precautions are necessary to prevent the transmission of TB via airborne droplets. These precautions include wearing an N95 respirator mask and placing the client in a negative-pressure isolation room.
F. Pyrazinamide is part of the standard multidrug regimen used to treat TB. It works by killing the TB bacteria in different stages of their life cycle, helping to eradicate the infection more effectively.
G. Rifampin is another essential medication used in the treatment of TB. It works by inhibiting the synthesis of bacterial RNA, thereby killing the TB bacteria. Rifampin is usually given in combination with other TB medications to prevent drug resistance.
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