An older adult client is brought to the clinic for Increased confusion over the past three days and presents with a draining wound on the right leg. Which assessment is most important for the nurse to obtain?

24-hour medication history.

Amount of serous drainage from the wound.

Urinary output for past six hours.

White blood cell count.

Answer and Explanation

The Correct Answer is D

A. While the medication history can be relevant, it is not the most immediate assessment needed to address the confusion and possible infection.

B. The amount of serous drainage is important for wound assessment but does not directly address the cause of confusion.

C. Urinary output is useful for evaluating kidney function but may not be directly related to the client’s confusion and wound.

D. The white blood cell count is crucial for identifying an infection or inflammatory response, which could be related to both the confusion and the wound.

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Correct Answer is A

Explanation

A. The nurse should call for an assistant to take over the tracheostomy care so the nurse can respond to the code blue.

B. Closing the room door is not an appropriate response in this emergency situation.

C. Finishing the procedure would delay the nurse’s response to the code blue, which is urgent.

D. Responding to the code is crucial, but the nurse should ensure the client's tracheostomy care is continued by calling for assistance first.

A. Ear pain and fever. B. Positive Epstein-Barr, and malaise. C. Increased BUN and serum creatinine. D. Elevated WBC and sedimentation rate.

Correct Answer is B

Explanation

A. Ear pain and fever are not characteristic symptoms of mononucleosis.

B. Mononucleosis is often associated with a positive Epstein-Barr virus (EBV) test and symptoms of malaise, fatigue, and lymphadenopathy.

C. Increased BUN and serum creatinine indicate kidney function issues, which are not typically associated with mononucleosis.

D. While elevated WBC and sedimentation rate can occur, they are nonspecific and can be seen in many conditions; they are not defining symptoms of mononucleosis.

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An older adult client is brought to the clinic for Increased confusion over the past three days and presents with a draining wound on the right leg. Which assessment is most important for the nurse to obtain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is performing tracheostomy care for a client when a code blue is called for another client on the unit who experiences a cardiopulmonary arrest. Which action should the nurse take?

Correct Answer is A

Explanation

The nurse caring for a child with mononucleosis can expect the child to exhibit which symptoms?

Correct Answer is B

Explanation

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