An adult is admitted with acute flank pain, a 102° F (38.9° C) oral temperature, hematuria, dysuria, urgency, and fishy-smelling urine. Which admitting prescription(s) are most important for the nurse to implement? Select all that apply.

Give diphenhydramine prep for intravenous pyelogram.

Obtain clean catch urine for culture and sensitivity.

Force oral fluids to 2,000 mL/24 hours.

Initiate broad spectrum IV antibiotic as secondary infusion.

Collect a serum sample for hemoglobin and hematocrit.

Answer and Explanation

Correct Answer : B,D

A. Diphenhydramine is unnecessary for diagnosing pyelonephritis.
B. Urine culture confirms bacterial infection and guides antibiotic therapy.
C. Forcing fluids may help but is not the priority over antibiotics and cultures.
D. Broad-spectrum IV antibiotics are critical to treat systemic infection.
E. Hemoglobin and hematocrit are not priority tests for pyelonephritis.

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Correct Answer is ["A","B","E","F","H"]

Explanation

Heart Rate: 128 beats/min (Sinus Tachycardia): Sinus tachycardia can be a compensatory response to hypovolemia, internal bleeding, or pain. Given the liver and spleen lacerations identified on the CT scan and blood in the peritoneum, tachycardia may indicate ongoing hemorrhage or hypoperfusion.

Blood Pressure: 90/79 mmHg (Narrow Pulse Pressure): A pulse pressure of less than 40 mmHg suggests inadequate perfusion and possible hemorrhagic shock. The systolic blood pressure (90 mmHg) is at the lower limit of normal, but the diastolic pressure (79 mmHg) is elevated, which can indicate compensatory vasoconstriction due to hypovolemia. Immediate fluid resuscitation or blood transfusion may be required to prevent worsening shock.

Temperature: 96.9°F (36.1°C): Trauma clients, especially those with hemorrhage, are at risk for trauma triad of death (hypothermia, acidosis, coagulopathy) due to massive fluid shifts and blood loss. Even mild hypothermia can impair coagulation and worsen bleeding, requiring active warming measures (e.g., warm IV fluids, heated blankets).

Abdominal Ecchymosis and Hematoma: Significant bruising around the surgical dressing suggests ongoing internal bleeding or vascular injury.

Close monitoring is needed to assess for expanding hematoma, increased abdominal distension, or hemodynamic instability.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

Describing heart rate patterns: Fetal heart rate patterns are essential indicators of the fetus's response to labor. By teaching the client about these patterns, the nurse can help the client understand what is normal and what may signal potential distress, helping to alleviate anxiety and provide education during labor.

Continuous fetal monitoring: Continuous fetal monitoring is a key tool for assessing the fetus's well-being during labor. It helps the nurse track the fetal heart rate and identify any abnormal patterns that could indicate fetal distress, such as late decelerations or significant variability.

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An adult is admitted with acute flank pain, a 102° F (38.9° C) oral temperature, hematuria, dysuria, urgency, and fishy-smelling urine. Which admitting prescription(s) are most important for the nurse to implement? Select all that apply.

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["A","B","E","F","H"]

Explanation

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

After the nurse witnesses a preoperative client signing the surgical consent form, the nurse signs the form as a witness. Which is (are) the legal implication(s) of the nurse's signature on the client's surgical consent form? Select all that apply.

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