Exhibits
According to the lab values, the client has
The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A","dropdown-group-3":"B"}
The client has a history of trauma with abdominal injury (lacerations to the liver and spleen) and blood in the peritoneum, indicating significant internal bleeding.
Hypovolemia (low blood volume) occurs due to blood loss from the injured organs, leading to low blood pressure (90/79 mmHg) and tachycardia (HR 128 bpm). The low hemoglobin (9.3 g/dL) and low hematocrit (30%) are consistent with either acute blood loss or hemodilution due to intravenous fluid resuscitation, which can temporarily dilute blood components. The normal clotting times (PT 11.5 sec, PTT 64 sec) do not indicate disseminated intravascular coagulation (DIC), and there is no evidence of acidosis in the provided data.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. The fall at home is part of the background information, but the immediate concern is the client’s changing mental status.
B. The sudden onset of increasing confusion and agitation could indicate a serious complication, such as delirium, infection, or a neurological issue. This is the priority to report to the healthcare provider.
C. While medication history is important, it is not as urgent as addressing the client’s current confusion.
D. The healthcare power of attorney is relevant for decision-making but not the first information needed in this urgent situation.
Correct Answer is C
Explanation
A. Identify information as late entry in the record. This action would only be necessary after the issue is resolved and documentation is restored.
B. Print electronic medical record (EMR) from backup server. While printing from the backup server is an option, notifying IT should be done first to address the root cause of the issue.
C. Notify Information services department of the situation. The IT department can assist in troubleshooting the issue and restoring the system to normal function.
D. Wait for notification that the system has been rebooted. It’s important to act proactively by notifying IT to help resolve the problem.
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