Exhibits
After the nurse assesses the client, the healthcare provider writes prescriptions. The nurse reviews the prescriptions. Which 2 prescriptions should the nurse complete first?
Perform pulmonary function test
Measure vital signs
Apply oxygen 1 L/minute
Give albuterol as ordered
Provide a regular diet tray
Correct Answer : C,D
Based on the client’s current condition and the urgency of the interventions, the nurse should complete the following prescriptions first:
- C) Apply oxygen 1 L/minute: The client’s oxygen saturation level needs to be kept above 94%. Given her difficulty in breathing and the fact that she is pale and sitting upright, it’s crucial to ensure she is receiving enough oxygen.
- D) Give albuterol as ordered: Albuterol is a bronchodilator that can help relieve the client’s asthma symptoms. Since her symptoms did not resolve after taking her usual dose of albuterol, administering another dose as ordered can help improve her breathing.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Reassuring the client that the nurse will return after all vital signs are taken might not be the most appropriate action in this situation. The client is critically ill and might need immediate emotional support.
Choice B rationale
Pulling up a chair and sitting beside the client’s bed is the most appropriate action. This action shows empathy and provides emotional support, which is crucial in the care of critically ill patients.
Choice C rationale
Allowing the client to hold the nurse’s hand until the vital signs can be completed might provide some comfort to the client. However, it might not be feasible if the nurse needs to use both hands to complete the vital signs.
Choice D rationale
Telling the client that he must release the nurse’s hand might not be the most appropriate action. It might come across as dismissive and could potentially upset the client.
Correct Answer is ["A","B","C","D"]
Explanation
D.
Choice A rationale
Administering morphine as prescribed would help to manage the patient’s reported pain.
Choice B rationale
Monitoring the patient’s vital signs is crucial in assessing the patient’s physiological response to the fall and ensuring stability.
Choice C rationale
Applying a cold pack to the affected area can help to reduce swelling and alleviate pain.
Choice D rationale
Arranging for an X-ray of the left shoulder would help to identify any potential fractures or other injuries resulting from the fall.
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