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Exhibits

The nurse is caring for the client the morning after her surgery.

Click to select the 5 most important nursing interventions for postoperative client care.

Encourage sitting up and ambulation

Monitor for bleeding once daily

Use Incentive spirometer every 1 hour

Promote adequate hydration

Assess for sedation after pain medications

Complete neurologic assessment every 2 hours

Administer pain medication after activity

Answer and Explanation

Correct Answer : A,C,D,E,G

A. Early ambulation helps prevent complications such as atelectasis, pneumonia, and deep vein thrombosis (DVT). It also promotes intestinal motility.
B. Monitoring for bleeding should be more frequent, especially in the immediate postoperative period, rather than just once daily.
C. This helps prevent respiratory complications such as atelectasis and promotes lung expansion.
D. Adequate hydration is essential to maintain fluid balance, promote healing, and prevent complications such as urinary tract infections and constipation.
E. Monitoring for sedation is crucial to ensure that pain medications are not causing excessive drowsiness, which could impair the client's ability to participate in activities such as ambulation and use of the incentive spirometer.
F. While assessing neurological status is important, frequent neurological assessments are more relevant for clients with neurological conditions or concerns. In this case, routine assessments should be sufficient unless the client has specific neurological symptoms.
G. Administering pain medication after activity helps manage pain more effectively and encourages the client to engage in necessary postoperative activities.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

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Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C

Explanation

A: While the spacer can reduce the risk of mouth infections, its primary purpose is to improve medication delivery to the lungs.

B: The spacer does not slow down the medication’s entry into the lungs, but it does enhance its delivery.

C: The spacer helps ensure that more medication reaches the lungs by holding the medication in the chamber before the client inhales it. This increases the effectiveness of the inhaler and reduces the risk of side effects, like oral thrush.

D: The spacer does not slow down inhalation to allow the client to inhale the entire dose. Instead, it holds the medication to ensure more is inhaled.

A. Disagree with the statement and set clear limits on talking about it. B. Immediately inform the healthcare provider that the client is experiencing a delusional episode. C. Attempt to comfort the client by agreeing with the delusions and ask open ended questions. D. Present a personal perception of reality in a nonconfrontational manner.

Correct Answer is D

Explanation

A. Disagree with the statement and set clear limits on talking about it. Disagreeing can cause conflict and worsen the delusion, making it important to use a nonconfrontational approach.
B. Immediately inform the healthcare provider that the client is experiencing a delusional episode. While the provider should be informed later, the immediate action should be to address the delusion with care.
C. Attempt to comfort the client by agreeing with the delusions and ask open-ended questions. Agreeing with delusions reinforces them and does not address the underlying issue.
D. Present a personal perception of reality in a nonconfrontational manner. Gently correcting the client's delusion by presenting reality helps the client understand the situation without challenging their beliefs directly, which could escalate anxiety.

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Exhibits The nurse is caring for the client the morning after her surgery. Click to select the 5 most important nursing interventions for postoperative client care.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client who has emphysema and recently experienced a stroke receives a prescription for a metered-dose inhaler with a spacer device. The client asks the nurse if using the spacer is necessary. Which information should the nurse provide?

Correct Answer is C

Explanation

The nurse is caring for a client who has a history of experiencing delusions. The client describes singing in a concert in the afternoon for thousands of people. Which action should the nurse take?

Correct Answer is D

Explanation

Exhibits The nurse suspects elder mistreatment. Click to indicate if the listed manifestation of abuse is consistent with physical abuse, abandonment, or neglect. Each row must have only one response option selected.

A client admitted to the psychiatric unit diagnosed with major depression wants to sleep during the day, refuses to take a bath, and refuses to eat. Which nursing intervention should the nurse implement first?

Exhibits Which laboratory tests would be helpful in determining the plan of care for this client? Select all that apply.

Exhibits Which intervention(s) should the nurse initiate if elder mistreatment is suspected? Select all that apply.

The nurse knows that a medication has the side effect of orthostatic hypotension. Which assessment should the nurse make before administering the medication?

The nurse is working on an infectious disease unit. Which client should be assigned to a room with negative airflow, while requiring personnel to use a particulate respirator mask, and requiring staff to observe airborne, as well as standard precautions?

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

Exhibits

The nurse is caring for the client the morning after her surgery.

Click to select the 5 most important nursing interventions for postoperative client care.