Exhibits

A nurse is collecting data from a client following a thoracentesis. The nurse should notify the provider for which of the following findings? (Click on the "Exhibit" button for additional information about the client There are three tabs that contain separate categories of data.)

Respiratory rate

Blood pressure

Hematocrit

PCO2

Answer and Explanation

The Correct Answer is A

Choice A. Respiratory rate
Reason: After thoracentesis, it's crucial to monitor the patient's respiratory rate. An increased respiratory rate could indicate respiratory distress. In this case, the respiratory rate is 26/min, which is higher than the normal range (12-20 breaths per minute for an adult at rest). Therefore, the nurse should notify the provider about this finding.

Choice B. Blood pressure
Reason: The blood pressure of the patient is 110/76 mm Hg, which falls within the normal range (90/60 mm Hg to 120/80 mm Hg). Therefore, there is no need for the nurse to notify the provider about the patient's blood pressure.

Choice C. Hematocrit
Reason: The hematocrit level is 43%, which is within the normal range (38.8% to 50.0% for males, and 34.9% to 44.5% for females). Therefore, there is no need for the nurse to notify the provider about the patient's hematocrit level².

Choice D. PCO2
Reason: The PCO2 level is 37 mm Hg, which is within the normal range (35 to 45 mm Hg). Therefore, there is no need for the nurse to notify the provider about the patient's PCO2 level.

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Correct Answer is B

Explanation

Choice A reason: Caloric needs for a burn patient are typically higher due to the increased metabolic demand for healing, so restricting to 2,000 calories may not be sufficient.

Choice B reason: Changing gloves between wound care on different body parts is a standard infection control practice to prevent cross contamination.

Choice C reason: Administering a diuretic may be necessary if there is fluid overload, but it is not a routine action based solely on urine output unless specified by a physician.

Choice D reason: Limiting movement or bending of the affected extremities may be necessary initially, but movement is also important for recovery and should be encouraged as tolerated.

A. Sore throat B. Presence of gag reflex C. Blood pressure 110/78 mm Hg D. Facial edema

Correct Answer is D

Explanation

Choice A reason: A sore throat is a common and expected finding after a bronchoscopy due to the irritation caused by the procedure.

Choice B reason: The presence of a gag reflex is a normal finding and indicates that the reflex has returned after the procedure.

Choice C reason: A blood pressure of 110/78 mm Hg is within the normal range and does not need to be reported.

Choice D reason: Facial edema is not a typical finding after a bronchoscopy and could indicate an allergic reaction or other complication.

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Exhibits A nurse is collecting data from a client following a thoracentesis. The nurse should notify the provider for which of the following findings? (Click on the "Exhibit" button for additional information about the client There are three tabs that contain separate categories of data.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care to a client who has sustained deep partial thickness burns to the back of both legs. Which of the following actions should the nurse anticipate taking?

Correct Answer is B

Explanation

A nurse is collecting data from a client who had a bronchoscopy. Which of the following findings should the nurse report to the provider?

Correct Answer is D

Explanation

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Exhibits

A nurse is collecting data from a client following a thoracentesis. The nurse should notify the provider for which of the following findings? (Click on the "Exhibit" button for additional information about the client There are three tabs that contain separate categories of data.)