Exhibits

Click to indicate which interventions the nurse would include in the plan of care to support the expected outcomes of adequate epidural anesthesia on the mother and the fetus.

Each column must have a least one but may have more than response option selected

Side positioning

Urinary drainage

Assisting with pushing efforts

Administering IV fluids

Monitoring blood pressure

Answer and Explanation

The Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A,B"},"E":{"answers":"A,B"}}

Side positioning can help with pain relief and prevent hypotension, which is beneficial for both maternal and fetal well-being. Urinary drainage (B) is typically a maternal intervention to manage the effects of epidural anesthesia on bladder function. Assisting with pushing efforts is a maternal intervention that supports the mother during the second stage of labor. Administering IV fluids is an intervention for the mother to maintain hydration and blood pressure, which indirectly benefits the fetus. Monitoring blood pressure is essential for both maternal and fetal health, as stable maternal blood pressure is critical for adequate fetal perfusion.

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Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"}}

Explanation

A. Teach the client how to count carbohydrates - Non-urgent. While essential for long- term management of diabetes, carbohydrate counting is not immediately critical in the acute management phase of HHS in the ICU. This teaching should be delayed until the patient is stabilized.
B. Stop the insulin infusion - Contraindicated. Stopping insulin in a patient with HHS, which is characterized by severe hyperglycemia, would be harmful. Insulin therapy is critical to reduce blood glucose levels safely.

C. Decrease the frequency of blood glucose tests - Contraindicated. Frequent monitoring is crucial in managing HHS, especially when insulin therapy is being administered, to prevent hypoglycemia and to monitor the effectiveness of treatment.
D. Start the client on a regular diet - Contraindicated. Introducing a regular diet during the acute phase of HHS could exacerbate the hyperglycemia. Nutritional needs should be assessed and managed carefully, typically starting with IV fluids and gradually transitioning to enteral or oral feeding as the patient stabilizes.
E. Decrease the insulin IV infusion to 0.05 units/kg/hr- Indicated. As blood sugar levels decrease, the insulin infusion rate may be cautiously reduced to prevent hypoglycemia.

A. Promote active range-of-motion activities. B. Request that the provider prescribe a stool softener. C. Avoid gas-producing foods. D. Add fluid and fiber to the diet.

Correct Answer is D

Explanation

A. While physical activity is important for overall health, it may not directly address constipation. Increasing fluid and fiber intake is a more specific intervention.

B. Stool softeners can be helpful, but dietary modifications should be attempted first before resorting to medications.
C. Gas-producing foods may not be directly related to constipation. The focus should be on promoting regular bowel movements through diet and hydration.
D. Increasing fluid and fiber intake is a recommended first-line approach for managing constipation in older adults.

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Exhibits Click to indicate which interventions the nurse would include in the plan of care to support the expected outcomes of adequate epidural anesthesia on the mother and the fetus. Each column must have a least one but may have more than response option selected

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Exhibits Nursing actions: Indicated/contraindicated/non-urgent

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"B"},"C":{"answers":"B"},"D":{"answers":"B"},"E":{"answers":"A"}}

Explanation

A nurse is caring for an older adult client who has constipation. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

Exhibits Review H and P, nurse's notes, laboratory results, flow sheet, and orders. Drag from Word Choices to complete the sentence. The client receiving epidural anesthesia would be at risk for developingdue to

After receiving a change of shift report for clients on a medical surgical unit, which activity should the nurse delegate to the practical nurse (PN)?

During discharge teaching, an overweight client with heart failure (HF) is asked to make a grocery list for the nurse to review. What food choice(s) included on the client's list should the nurse encourage? Select all that apply.

The nurse is assigned to care for four surgical clients. After receiving report, which client should the nurse see first?

Exhibits Drag from the word choices to complete the sentence The client demonstrates effective epidural anesthesia by and ,

The adult child of an older adult client who has Parkinson's disease, calls the clinic and reports that the client has been confused for the past week. What action(s) should the nurse take? Select all that apply.

A client with a prescription for "do not resuscitate" (DNR) begins to manifest signs of impending death. After notifying the family of the client's status, which priority action should the nurse implement?

Exhibits

Click to indicate which interventions the nurse would include in the plan of care to support the expected outcomes of adequate epidural anesthesia on the mother and the fetus.

Each column must have a least one but may have more than response option selected