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 C

Explanation

When teaching a patient with newly diagnosed GERD, the nurse will include that they will need to keep the head of their bed elevated on blocks. This helps prevent stomach acid from ﬂowing back into the esophagus while sleeping.

Peppermint tea might not be helpful in reducing GERD symptoms as it can relax the lower esophageal sphincter and worsen reﬂux.

Eating between meals is not recommended as it can increase acid secretion. Vigorous physical activities may increase the incidence of reﬂux.

A. Assess the patient’s perception of what it means to have type 2 diabetes. B. Ask the patient’s family to participate in the diabetes education program. C. Demonstrate how to check glucose using capillary blood glucose monitoring. D. Discuss the need for the patient to actively participate in diabetes management.

Correct Answer is A

Explanation

The first step in the education plan should be to assess their understanding and perception of the disease. This will help the nurse to identify any misconceptions or knowledge gaps that the patient may have and tailor the education plan accordingly. Understanding the patient's perceptions will also help the nurse to establish a trusting relationship with the patient and increase their engagement in diabetes self-management.
Options b, c, and d are important components of the diabetes education plan, but they should be implemented after the initial assessment of the patient's perception and understanding of their diagnosis.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which information will the nurse include when teaching a patient with newly diagnosed GERD?

Correct Answer is C

Explanation

Mary, a 63-year-old patient is newly diagnosed with type 2 diabetes. When determining an education plan, the nurse’s first action should be to?

Correct Answer is A

Explanation

A patient with suspected acromegaly is seen at the clinic. To assist in making the diagnosis, which question should the nurse ask?

During the nursing assessment of a patient with Graves' disease. The nurse notes a bounding, rapid pulse and systolic hypertension. Based on these assessment data, which question is important for the nurse to ask the patient?

A patient is admitted to the hospital in Addisonian Crisis a month after a diagnosis of Addison’s disease. The nurse identifies the nursing diagnosis of ineﬀective therapeutic regimen management related to lack of knowledge of management of the condition when the patient says:

A nurse is planning care for a client who has acute gastritis. Which of the following nursing interventions should NOT be included in the plan of care?

The nurse is admitting a patient who is nauseated and vomiting up blood-streaked ﬂuid with diagnosis of acute gastritis. When obtaining the admission health history, it will be most important for the nurse to ask the patient about:

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