Exhibits
The nurse performs an initial focused assessment of the client.
Based on the client's history and assessment data, the nurse's hypothesis is that the client's vital signs are most likely the result of disease process, medication use, or neither. Each column must have at least one, but may have more than one answer selected.
Blood pressure 130/86 mm Hg
Temperature 98.9" F (37.1° C)
Oxygen saturation 88% on room air
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"}}
- Blood pressure 130/86 mm Hg
- Neither Disease Process Nor Medication: This blood pressure reading is within the normal range for an adult and does not indicate a specific disease process or medication effect.
- Temperature 98.9° F (37.1° C)
- Neither Disease Process Nor Medication: This temperature is within the normal range and does not indicate a specific disease process or medication effect.
- Oxygen saturation 88% on room air
- Disease Process: This low oxygen saturation level is likely due to the acute asthma attack, which is a disease process affecting the client's ability to oxygenate properly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["125"]
Explanation
Infusion rate (mL/hr) = Volume to be infused (mL) / Time (hr)
In this case:
- Volume to be infused = 1 L = 1000 mL
- Time = 8 hours
Plugging the values into the formula:
- Infusion rate = 1000 mL / 8 hours = 125 mL/hr
Correct Answer is ["0.4"]
Explanation
Volume (mL) = Desired dose (units) / Concentration (units/mL)
In this case:
- Desired dose = 200,000 units
- Concentration = 500,000 units/mL
Plugging the values into the formula:
- Volume = 200,000 units / 500,000 units/mL = 0.4 mL
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