A with acute Gl bleeding is receiving normal saline IV at a rate of 500 ml/hr. Which assessment data obtained by the nurse are most important to communicate immediately to the healthcare provider?

The patient's lungs have crackles audible to the midline.

The patient's BP has increased to 142/94 mm Hg.

The bowel sounds are very hyperactive in all four quadrants.

The NG suction is returning coﬀee-ground material.

Answer and Explanation

The Correct Answer is D

Coﬀee-ground material in the NG suction indicates that there is active bleeding in the upper gastrointestinal tract, which could be a life-threatening situation. This requires immediate medical attention and intervention to control the bleeding and stabilize the patient.

Options A, B, and C are also important assessment data, but they are not as urgent as option D in this scenario.

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Correct Answer is A

Explanation

This meal choice is low in sodium as it contains fresh ingredients and does not include processed or pre-packaged foods that are typically high in sodium. Chicken, bread, and carrots are naturally low in sodium, and the client can control the amount of added salt or seasoning. In contrast, the other food choices are likely to be high in sodium due to added salt, cheese, or processed ingredients.

Therefore, the nurse should encourage the client to choose fresh, low-sodium foods and avoid processed or pre-packaged meals.

A. You really should not worry about how you look in the hospital, we see many worse things. B. Most of the physical and mental changes caused by the disease will gradually improve after surgery. C. "Let me show you how to dress so that the changes are not so noticeable." D. "I do not think you look bad; your appearance is just altered by your disease.

Correct Answer is B

Explanation

This response acknowledges the patient's concerns and provides reassurance that the changes are temporary and will improve after surgery. Response is dismissive of the patient's concerns and may make the patient feel unheard. Response c may be helpful, but it does not address the patient's emotional concerns. Response d is not accurate because the patient has expressed feeling awful about their appearance.

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A with acute Gl bleeding is receiving normal saline IV at a rate of 500 ml/hr. Which assessment data obtained by the nurse are most important to communicate immediately to the healthcare provider?

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Naxlex Comprehensive Predictor Exams

A client has been taught to restrict dietary sodium. Which food selection by the client indicates to the nurse that teaching has been eﬀective?

Correct Answer is A

Explanation

A patient with crushing syndrome is admited to the hospital to have laparoscopic adrenalectomy. During the admission assessment, the patient tells the nurse "The worst thing about this disease is how terrible I look; I feel awful about it.' The best response by the nurse is:

Correct Answer is B

Explanation

A program of weight loss and exercise is recommended for a patient with impaired fasting glucose (IFG). When teaching the patient about the reason for these lifestyle changes, the nurse will tell the patient that:

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The physical environment and traffic control measures of the operating room are designed primarily to:

Trimethoprim and sulfamethoxazole (Bactrim) BID for 7 days is ordered for a patient who has a recurrent relapse of an Escherichia coli UTI. The nurse instructs the patient to

A patient is hospitalized with acute adrenal insufficiency. The nurse determines that the patient is responding favorably to treatment on finding:

A with acute Gl bleeding is receiving normal saline IV at a rate of 500 ml/hr. Which assessment data obtained by the nurse are most important to communicate immediately to the healthcare provider?

A 98-year-old patient with benign prostatic hyperplasia has a markedly distended bladder and is agitated and confused. All the following orders are received from the emergency department health care provider. Which order should the nurse act on first?