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Exhibits

Select the 2 findings that indicate the client's condition is improving.

Temperature

Blood glucose

WBC

Heart rate

Urinary frequency

Blood pressure

Wound appearance

Answer and Explanation

Correct Answer : B,E

Rationale for Correct Choices

Blood glucose: The client’s blood glucose decreased from 250 mg/dL to 140 mg/dL, indicating a positive response to diabetes management through medication and dietary adherence. This is a key marker of metabolic control in diabetes.
Urinary frequency: Two weeks ago, the client reported "frequent urination" (polyuria), which is a classic symptom of uncontrolled hyperglycemia. Today, this symptom is not reported, and given the improvement in blood glucose, it's highly probable that the polyuria has resolved or significantly decreased.

Rationale for Incorrect Choices

Temperature: The client’s temperature increased from 38.3°C to 39.0°C, suggesting a worsening or persistent infection. An increasing fever is a negative trend and does not indicate improvement.
WBC: The WBC count rose from 9,500/mm³ to 11,200/mm³, exceeding the normal upper limit. This may reflect an active or worsening infection, especially in the context of a draining foot wound and elevated temperature.
Heart rate: The heart rate remains elevated at 106/min (tachycardia) compared to the previous 104/min. Persistent tachycardia can be a sign of systemic infection or dehydration and is not a sign of clinical improvement.
Blood pressure: The blood pressure decreased from 98/74 mm Hg to 90/68 mm Hg, which may suggest worsening hemodynamic status and possible sepsis. Hypotension is not an indicator of improvement.

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Correct Answer is C

Explanation

A. Decreased urinary output: Decreased urinary output can occur in heart failure due to reduced kidney perfusion, but it is more commonly associated with left-sided heart failure as it leads to fluid congestion in the lungs and a decreased ability of the kidneys to function effectively.

B. Cool extremities: Cool extremities can occur in heart failure, but they are more commonly seen in left-sided heart failure due to poor circulation from the left ventricle. Right-sided heart failure primarily affects the systemic circulation.

C. Peripheral edema: Peripheral edema is a hallmark sign of right-sided heart failure. The right side of the heart is unable to pump blood efficiently to the lungs, causing blood to back up into the veins and resulting in fluid retention in the lower extremities and other parts of the body.

D. Crackles in the lung fields: Crackles in the lung fields are a characteristic finding in left-sided heart failure, as fluid backs up into the lungs. This is not typically a finding associated with right-sided heart failure, which affects the systemic circulation.

A. Constipation B. Serum albumin 5.2 g/dL (3.5 to 5 g/dL) C. Apnea alternating with hyperventilation D. Peripheral edema

Correct Answer is C

Explanation

A. Constipation: While constipation is a common symptom in terminally ill clients, it is a manageable condition that does not necessarily indicate the need for palliative care. It can be addressed with medication and lifestyle adjustments.

B. Serum albumin 5.2 g/dL (3.5 to 5 g/dL): This is within normal range and does not suggest a need for palliative care. Normal albumin levels indicate adequate nutritional status and liver function, so there is no immediate indication for palliative care based on this finding.

C. Apnea alternating with hyperventilation: Apnea alternating with hyperventilation is a sign of impending respiratory failure, which can be a symptom of terminal illness and often occurs in the final stages of life. This indicates that the client may benefit from palliative care to address comfort and end-of-life needs.

D. Peripheral edema: Peripheral edema can occur due to causes such as heart failure or kidney dysfunction. While it can be distressing, it does not necessarily indicate that palliative care is required. It can be treated with medical interventions and does not imply end-of-life.

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Exhibits Select the 2 findings that indicate the client's condition is improving.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has right-sided heart failure. The nurse should assess the client for which of the following manifestations?

Correct Answer is C

Explanation

A nurse is caring for a client who is terminally ill. Which of the following findings should the nurse identify as an indication that palliative care should be recommended?

Correct Answer is C

Explanation

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A nurse is caring for a client who develops third-degree heart block with a heart rate of 30/min. Which of the following actions should the nurse take?

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Exhibits

Select the 2 findings that indicate the client's condition is improving.