A post-operative patient is at risk for developing a wound infection. Which of the following nursing assessments is the highest priority to prevent this complication?

Monitoring the patient's vital signs

Assessing the patient's pain level

Inspecting the surgical incision site for redness, swelling

Assessing the patient's fluid intake and output

Answer and Explanation

The Correct Answer is C

A.   While important for overall patient assessment, it's not the most direct way to monitor for a wound infection.
B.   Pain can indicate a wound infection, but it's not as specific as directly inspecting the wound.
C.   This is the most direct way to assess for early signs of a wound infection. Redness, swelling, warmth, and drainage are classic signs of infection.
D.   Important for overall patient care, but not specifically related to wound infection prevention.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is A

Explanation

A. pH: Elevated (above 7.45), indicating alkalosis. PaCO₂: Decreased (below 35 mm Hg), reflecting hyperventilation and CO₂ loss. HCO₃⁻: Usually normal (around 24 mEq/L) or slightly decreased, as metabolic compensation might not be immediate. The results here show an elevated pH, decreased PaCO₂, and normal HCO₃⁻, which are consistent with respiratory alkalosis.
B. pH: Decreased (acidic), indicating acidosis. PaCO₂: Slightly elevated (near normal), not indicative of respiratory alkalosis. HCO₃⁻: Normal (around 26 mEq/L), suggesting no significant metabolic component or compensation. This profile does not match respiratory alkalosis; it is more consistent with a mixed or different type of acid-base imbalance.
C. pH: Decreased (acidic), indicating acidosis. PaCO₂: Elevated (above 45 mm Hg), indicating CO₂ retention, which is characteristic of respiratory acidosis, not alkalosis. HCO₃⁻: Normal (around 23 mEq/L), showing no significant metabolic compensation or disturbance. This profile indicates respiratory acidosis rather than respiratory alkalosis.
D. pH: Elevated (alkaline), which is consistent with alkalosis. PaCO₂: Normal (around 40 mm Hg), indicating that CO₂ levels are not the primary cause of the alkalosis. HCO₃⁻: Elevated (above 28 mEq/L), suggesting a metabolic alkalosis or compensation for a respiratory acidosis, but not respiratory alkalosis alone.

A. Administering preoperative medications to the patient B. Witnessing the patient's signature on the consent form C. Explaining the surgical procedure to the patient D. Monitoring the patient's vital signs during the procedure

Correct Answer is B

Explanation

A. Administering preoperative medications is a nursing responsibility but not directly related to informed consent.
B. Witnessing the patient's signature is the nurse's primary responsibility regarding informed consent in the preoperative period. This verifies that the patient understands the procedure and voluntarily agrees to it.
C. Explaining the surgical procedure is the responsibility of the surgeon or physician.
D. Monitoring vital signs is a postoperative responsibility.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

A post-operative patient is at risk for developing a wound infection. Which of the following nursing assessments is the highest priority to prevent this complication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which blood gas result will the nurse expect to observe in a patient with respiratory alkalosis?

Correct Answer is A

Explanation

During the preoperative period, what is the nurse's responsibility regarding informed consent?

Correct Answer is B

Explanation

A nurse is suctioning the endotracheal tube of a client who is on a ventilator. The client's heart rate increases from 86/min to 110/min and becomes irregular. Which of the following actions should the nurse take?

Which of the following statements accurately reflects the relationship between obesity and surgical risk?

A nurse teaches a post-operative patient about preventing atelectasis. Which statement by the patient indicates an understanding?

A nurse is caring for a client with a tracheostomy. The client's partner has been taught to perform suctioning. Which of the following actions by the partner should indicate to the nurse a readiness for the client's discharge?

A nurse is assessing a client who has respiratory acidosis. Which of the following findings should the nurse expect?

Which of the following is a potential consequence of consuming alcohol prior to an outpatient surgical procedure involving anesthesia?

A nurse is teaching a client who has COPD about purse-lipped breathing. Which of the following statements should the nurse make?