A nurse supervisor receives notification of a disaster in the community and the possibility for multiple admissions to the facility. Which of the following clients should the nurse recommend for discharge?
A client who is experiencing an exacerbation of COPD and has been BiPap at night.
A client who is 1 day postoperative following a laparoscopic cholecystectomy and has a temperature of 37.7° C (99.9° F).
A client who reports intermittent chest pain and has received nitroglycerin four times in the past 8 hr.
A client who is receiving a continuous insulin infusion of 5 units/hr following an episode of DKA 2 hr ago.
The Correct Answer is B
Choice A reason: A client with COPD requiring BiPap at night is unstable and at risk for respiratory failure. Discharging them would be unsafe.
Choice B reason: A client who is 1 day postoperative after a laparoscopic cholecystectomy with a low-grade temperature is stable. They can safely continue recovery at home with outpatient follow-up. This makes them the best candidate for discharge.
Choice C reason: A client with intermittent chest pain requiring multiple doses of nitroglycerin is unstable and at risk for myocardial infarction. They require close monitoring and cannot be discharged.
Choice D reason: A client on continuous insulin infusion for recent DKA is unstable and requires ongoing inpatient care. Discharging them would be unsafe.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Pressured speech is a hallmark of a manic episode. Clients often speak rapidly, loudly, and without pause, making it difficult for others to interrupt. This reflects heightened energy, racing thoughts, and decreased need for sleep, all characteristic of mania.
Choice B reason: Blunted affect is more commonly associated with depressive episodes or schizophrenia, not mania. In mania, affect is typically expansive, elevated, or irritable, not blunted.
Choice C reason: Catalepsy, a state of muscular rigidity and fixed posture, is associated with catatonic schizophrenia or neurological disorders, not bipolar mania. It is not expected in this scenario.
Choice D reason: Echopraxia, the involuntary imitation of another person’s movements, is also associated with catatonia or certain neurological conditions. It is not a feature of mania.
Correct Answer is A
Explanation
Choice A reason: Consuming additional calories each day is essential to support milk production. Breastfeeding mothers require approximately 450–500 extra calories daily to meet the increased metabolic demands of lactation. Adequate nutrition ensures sufficient milk supply and maternal health, making this the correct teaching.
Choice B reason: Avoiding seafood entirely is unnecessary. While certain fish high in mercury should be limited, many types of seafood are safe and provide beneficial omega-3 fatty acids. Blanket avoidance is not evidence-based.
Choice C reason: Waiting 1 hour after consuming alcohol is not sufficient. Alcohol passes into breast milk, and the recommended guideline is to avoid alcohol altogether or wait at least 2–3 hours per drink before breastfeeding. Therefore, this statement is inaccurate.
Choice D reason: Caffeine does enter breast milk, but it does so quickly, not slowly. Moderate caffeine intake (about 200–300 mg/day) is generally safe, but excessive intake can cause irritability and poor sleep in infants. The statement is misleading and incorrect.
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