Exhibits

Based on the assessment and blood gas results, which 3 orders should the nurse expect from the healthcare provider?

Give a bolus of 1,000 mL 0.9% sodium chloride

Repeat blood gas in 1 hour

Place the client in a prone position

Perform endotracheal suctioning

Chest x-ray now

Administer inhaled corticosteroid

Answer and Explanation

Correct Answer : B,C,D

A. Giving a bolus of 1,000 mL 0.9% sodium chloride is typically used to treat hypovolemia or electrolyte imbalances, which are not indicated by the patient's current lab values or clinical
situation.
B. Repeating the blood gas in 1 hour is a reasonable order as it would provide information on whether the patient's respiratory status is improving following interventions for ventilator-associated pneumonia.
C. Placing the client in a prone position can improve oxygenation in patients with respiratory distress by redistributing lung perfusion, making it a suitable intervention for this patient with diminished breath sounds and crackles.
D. Performing endotracheal suctioning would help clear secretions, which may be contributing to the patient's diminished breath sounds and crackles, and is consistent with the care for a patient with pneumonia.
E. A chest x-ray now would typically be ordered if there was a suspicion of a new onset condition such as a pneumothorax or pleural effusion, which is not indicated by the patient's current presentation.
F. Administering an inhaled corticosteroid is generally used for long-term management of chronic respiratory conditions and is not typically used for acute management of ventilator-associated pneumonia.

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Correct Answer is D

Explanation

A. Infection: While infection can cause localized redness and swelling, deep vein thrombosis (DVT) is a more likely cause given the client's immobility and other risk factors.
B. Fat emboli: Fat emboli typically occur after trauma or orthopedic procedures, and their presentation is less likely in this scenario.
C. Pulmonary embolism: While a pulmonary embolism is a potential complication of DVT, it presents with symptoms such as dyspnea, chest pain, and tachypnea, rather than localized redness and swelling in the calf.
D. Deep vein thrombosis: This condition, characterized by redness and swelling in the affected limb, is common in immobile patients and those with dehydration, making it the most likely cause of the client's symptoms.

A. Connect the nasogastric tube to suction as prescribed. B. Clamp the nasogastric tube and contact the healthcare provider. C. Immediately remove and then reinsert the nasogastric tube. D. Connect the nasogastric tube to high continuous suction.

Correct Answer is B

Explanation

A. Connect the nasogastric tube to suction as prescribed: "Coffee ground" drainage can indicate the presence of blood in the stomach, which requires further assessment before initiating suction.
B. Clamp the nasogastric tube and contact the healthcare provider: Clamping the tube helps
prevent further aspiration of gastric contents, and contacting the healthcare provider is necessary for further evaluation and instructions.
C. Immediately remove and then reinsert the nasogastric tube: While removing and reinserting the tube may be necessary, contacting the healthcare provider for guidance is the priority.
D. Connect the nasogastric tube to high continuous suction: Initiating suction without further evaluation can exacerbate bleeding and is not appropriate without guidance from the healthcare provider.

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Exhibits Based on the assessment and blood gas results, which 3 orders should the nurse expect from the healthcare provider?

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Naxlex Comprehensive Predictor Exams

The nurse is completing an admission assessment on an older adult client with dehydration, failure to thrive, and who is immobile. The nurse reports to the healthcare provider that the client's right calf is red and swollen. The nurse should suspect which probable cause of these findings?

Correct Answer is D

Explanation

A client has a prescription for the insertion of a nasogastric tube to low intermittent suction. When inserting the nasogastric tube, the nurse observes an immediate return of "coffee ground" drainage. Which action should the nurse implement?

Correct Answer is B

Explanation

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The nurse is completing an admission assessment on an older adult client with dehydration, failure to thrive, and who is immobile. The nurse reports to the healthcare provider that the client's right calf is red and swollen. The nurse should suspect which probable cause of these findings?

Exhibits Based on the assessment and blood gas results, which 3 orders should the nurse expect from the healthcare provider?

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Exhibits

Based on the assessment and blood gas results, which 3 orders should the nurse expect from the healthcare provider?