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%).

Answer and Explanation

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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Correct Answer is B

Explanation

A. Positioning the client over an overbed table is not appropriate for a paracentesis procedure and may interfere with the procedure.
B. Emptying the bladder before the procedure helps to reduce the risk of accidental bladder puncture during paracentesis.
C. Administering IV fluids prior to the procedure is not typically indicated for a paracentesis, unless specifically ordered by the provider for hydration purposes.
D. NPO status is not typically required before a paracentesis procedure unless otherwise specified by the provider.

A. Suspicious of others B. Preoccupied with aging C. Exhibits separation anxiety D. Ritualistic behavior

Correct Answer is B

Explanation

A. Suspiciousness of others is more characteristic of paranoid personality disorder.

B. Preoccupation with aging is a common characteristic of narcissistic personality disorder. Individuals with this disorder often have an exaggerated sense of self- importance, a need for admiration, and a lack of empathy for others. Concerns about aging may stem from a fear of losing their perceived attractiveness or power.
C. Exhibiting separation anxiety is not typically associated with narcissistic personality disorder.
D. Ritualistic behavior may be seen in obsessive-compulsive personality disorder but is not a defining feature of narcissistic personality disorder.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client who is scheduled to have a paracentesis. Which of the following actions should the nurse include in the plan of care?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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