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Exhibits

Based on the client's status at 1400, the nurse should plan to do which of the following? Select all that apply.

Increase the fractional concentration of Inspired oxygen

Change the ventilator settings to continuous positive airway pressure (CPAP)

Increase the respiratory rate

Continue weaning the ventilator as ordered

Decrease the tidal volume

Alert the provider of the blood gas values

Switch the ventilator to pressure control

Answer and Explanation

Correct Answer : A,F,G

A.   Increase the fractional concentration of Inspired oxygen: As the partial pressure of oxygen (PaO) has decreased to 64 mm Hg from 99 mm Hg, and the oxygen saturation may drop, it's necessary to increase the fraction of inspired oxygen (FiO2) to maintain adequate oxygenation.
B.   Change the ventilator settings to continuous positive airway pressure (CPAP): CPAP is not typically used in patients who are intubated. CPAP is a non-invasive ventilation mode used for patients with respiratory distress who are breathing spontaneously. In this case, the patient is intubated and requires mechanical ventilation, so CPAP is not appropriate.
C.   Increase the respiratory rate: While the respiratory rate has decreased from 15 to 13 breaths/minute, it's important to maintain a careful balance when adjusting ventilator settings. Increasing the respiratory rate may not be necessary at this point, especially if the patient is still oxygenating adequately. Moreover, the primary concern appears to be hypoxemia rather than hypoventilation.
D.   Continue weaning the ventilator as ordered: While weaning the patient off the ventilator is a goal, it may not be appropriate at this time, especially with the worsening blood gas values
indicating respiratory insufficiency. Continuing the weaning process could potentially exacerbate respiratory failure.

E. Decrease the tidal volume: Decreasing the tidal volume could worsen ventilation-perfusion matching and exacerbate hypoxemia. This approach might be considered in certain cases of acute respiratory distress syndrome (ARDS) or in patients with severe lung injury, but it's not typically indicated in this scenario without further assessment.

F. Alert the provider of the blood gas values: The nurse should inform the provider about the changes in blood gas values, especially the decrease in PaO2 and the increase in PaCO2, which indicate worsening respiratory status and potential respiratory acidosis.

G. Switch the ventilator to pressure control: Given the deterioration in respiratory status with an increase in PaCO2 and decrease in PaO2, switching to pressure control ventilation may provide better control over the patient's ventilation and oxygenation, especially in cases of acute
respiratory failure.

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Correct Answer is A

Explanation

A. Avoid stimulation of the breasts and wear a tight bra: This is the most appropriate recommendation for a bottle-feeding postpartum client with breast engorgement. Minimizing breast stimulation and wearing a supportive, tight-fitting bra can help reduce milk production and alleviate discomfort.

B. Express a small amount of breast milk by hand: This action may provide temporary relief but can stimulate further milk production, which is not advisable for a client who is bottle-feeding and attempting to suppress lactation.

C. Place warm packs on both breasts: Warmth can promote milk flow and is typically recommended for breastfeeding mothers. For a bottle-feeding client, cold compresses are more appropriate to reduce engorgement.

D. Take a prescribed analgesic and expose breasts to air: While analgesics can help manage discomfort, exposing the breasts to air has no therapeutic benefit for engorgement and may increase discomfort. This is not the best overall recommendation.

A. These laboratory values will provide data to anticipate delays in growth and development. B. This is a routine blood test required by law to screen for metabolic deficiencies. C. Dosages for thyroid replacement therapy will be determined by this test. D. This technique is used for early detection of intellectual disabilities.

Correct Answer is B

Explanation

A. These laboratory values will provide data to anticipate delays in growth and development.
While abnormal results from these tests could indicate potential developmental issues, the primary purpose of the screening is not to predict delays in growth and development but to identify metabolic deficiencies.

B. This is a routine blood test required by law to screen for metabolic deficiencies.
This is the correct answer. Neonatal screening, including tests for T4 and TSH, is a standard practice mandated by law in many regions to identify metabolic deficiencies such as congenital hypothyroidism early on, ensuring prompt treatment to prevent serious health issues.

C. Dosages for thyroid replacement therapy will be determined by this test.
This explanation might be applicable if a deficiency is detected, but it is not the primary reason for conducting the initial screening. The primary purpose is to identify whether there is a need for treatment.

D. This technique is used for early detection of intellectual disabilities.
Although untreated metabolic deficiencies like congenital hypothyroidism can lead to intellectual disabilities, the primary goal of the screening is to detect and treat these deficiencies before they can cause such problems.

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Exhibits Based on the client's status at 1400, the nurse should plan to do which of the following? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A postpartum client who is bottle-feeding develops breast engorgement. Which is the best recommendation for the nurse to provide this client?

Correct Answer is A

Explanation

The nurse is collecting a heelstick blood specimen for a neonatal screen, which includes thyroxine (T4) and thyroid stimulating hormone (TSH) levels, prior to the discharge of a 2-day- old client. When the parents ask why these tests are being conducted, which explanation should the nurse provide?

Correct Answer is B

Explanation

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The nurse is teaching a group of women about osteoporosis and exercise. The nurse should emphasize the need for which type of regular activity?

A nurse is planning care for a client who is experiencing acute mania. Which of the following actions should the nurse include in the plan of care?

When entering a client's room to administer an 0900 IV antibiotic, the nurse finds that the client is engaged in sexual activity with a visitor. Which action should the nurse implement?

Exhibits

Based on the client's status at 1400, the nurse should plan to do which of the following? Select all that apply.