Exhibits
A nurse is planning care for a newly admitted client. Which of the following interventions should the nurse plan to take first?
Initiate an IV access for the client.
Administer pain medication to the client.
Send the client to radiology for a CT scan.
Insert an NG tube for the client.
The Correct Answer is A
A. Initiating IV access is a priority to establish a route for medication administration and fluid resuscitation, which are crucial in the management of acute pancreatitis.
B. Administering pain medication is important, but establishing IV access should be prioritized to ensure timely delivery of medications and fluids.
C. Sending the client to radiology for a CT scan may be necessary but should not take precedence over establishing IV access for immediate intervention.
D. Inserting an NG tube may be indicated later in the client's care but is not the first priority compared to establishing IV access.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "Wearing an underwire bra between feedings" can compress the breast tissue, potentially leading to milk stasis and increasing the risk of mastitis.
B. "Covering your breasts immediately after feedings" can trap moisture and warmth, creating an environment conducive to bacterial growth and increasing the risk of mastitis.
C. "Applying cold compresses to your breasts before feedings" may provide temporary relief for discomfort, but it is not a primary preventive measure for mastitis.
D. "Trying to have your baby empty your breasts with each feeding" helps ensure thorough milk removal, which can prevent milk stasis and decrease the risk of mastitis. This is the correct choice.
Correct Answer is C
Explanation
A. Encourage the client to ambulate in the hallway 1 hr before bedtime - While light exercise during the day can promote better sleep, exercising close to bedtime can actually disrupt sleep.
B. Tell the client to avoid drinking fluids 1 hr before bedtime - While limiting fluids close to bedtime can reduce nighttime awakenings to urinate, it may not directly address difficulty falling asleep.
C. Schedule routine care tasks during hours when the client is awake - This action ensures that the client can maximize restful sleep during the night by minimizing disruptions from care
activities.
D. Advise the client to leave the television in the room on when trying to fall asleep - Screen
time before bed can interfere with falling asleep due to the stimulating effect of light and content.
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