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Patient Data

Exhibits

What order(s) would the nurse question? (Select all that apply.)

Send blood for a complete blood count, electrolytes

Enalapril 10 mg every morning

C Ibuprofen 400 mg every 4 to 6 hours PRN for temperature greater than 100.5°F (38° C)

Admit to the medical floor

Supplemental oxygen 10 L/min via nasal cannula

Vital signs every 4 hours

Continuous pulse oximetry

Chest x-ray

Answer and Explanation

Correct Answer : C,E,H

A. Send blood for a complete blood count, electrolytes: This is appropriate for assessing the client's overall health status and electrolyte balance, which may be affected by pneumonia and enalapril therapy.

B. Enalapril 10 mg every morning: This is the client's maintenance dose of enalapril for managing hypertension, and it should be continued unless there are specific contraindications or concerns about renal function.

C. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase blood pressure and interfere with the antihypertensive effects of enalapril. Additionally, NSAIDs can potentially worsen renal function, which may already be compromised in a client with pneumonia.
D. Admit to the medical floor: This is appropriate for a client with pneumonia who may require close monitoring and management of respiratory status and other complications.
E. Supplemental oxygen 10 L/min via nasal cannula: High-flow oxygen can decrease respiratory drive and potentially worsen ventilation-perfusion (V/Q) matching, especially in clients with pneumonia.

F. Vital signs every 4 hours: Regular monitoring of vital signs is essential for assessing the client's response to treatment and identifying any signs of deterioration.

G. Continuous pulse oximetry: Continuous pulse oximetry provides real-time monitoring of oxygen saturation and helps assess the effectiveness of oxygen therapy and the client's respiratory status.

H. While a chest x-ray is often indicated for diagnosing pneumonia, ordering it "now" may not be necessary unless the client's condition is unstable or if there are specific concerns regarding the severity of the pneumonia

Nursing Test Bank

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

A. Inserting a nasogastric tube (NGT) and attaching it to low intermittent suction would be appropriate in this situation. Dark brown emesis could indicate gastrointestinal bleeding, which may require gastric decompression to prevent further vomiting and assess the volume and characteristics of the gastric contents.

B. Placing an indwelling urinary catheter and attaching a bedside drainage unit is not the priority intervention in this scenario.

C. Sending the client to x-ray for a flat plate of the abdomen may provide diagnostic information, but it is not the most immediate intervention needed in this situation.

D. Giving a prescribed analgesic for a temperature above 101°F (38.3°C) is not the priority intervention in this scenario.

A. Loperamide. B. Ipratropium. C. Famotidine. D. Aspirin.

Correct Answer is D

Explanation

D. Bismuth subsalicylate, a component of the regimen, has salicylate in its composition, which can lead to an increased risk of bleeding when taken with aspirin, a known blood thinner.

A. Loperamide is an antidiarrheal medication commonly used to treat diarrhea. It is not directly related to the treatment of Helicobacter pylori (H. pylori) infection.

B. Ipratropium is a bronchodilator medication used to treat conditions such as chronic obstructive pulmonary disease (COPD) and asthma. It is not directly related to the treatment of H. pylori infection.

C. Famotidine is a histamine-2 (H2) receptor antagonist commonly used to reduce stomach acid production. It is not directly related to the treatment of H. pylori infection.

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Patient Data Exhibits What order(s) would the nurse question? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

The healthcare provider prescribes bismuth subsalicylate, metronidazole, tetracycline, and pantoprazole for a client with a Helicobacter pylori (H. pylori) infection. Prior to administering the H. pylori treatment regimen, the nurse should review the electronic medical record for which medication?

Correct Answer is D

Explanation

An adult client with multiple sclerosis (MS) fell while walking to the bathroom. On transfer to the intensive care unit, the client is confused and has had projectile vomiting twice. Which intervention should the nurse implement first?

Patient Data Exhibits Which technique should the nurse use when assessing the client for early signs of rheumatoid arthritis?

An older adult client is hospitalized with a fractured femur. During a routine nursing assessment, the client repeatedly asks the nurse to "speak up" so that the client can hear the questions. Which action is best for the nurse to take?

A client is recovering from the surgical removal of glass in the right eye. Which intervention should the nurse implement immediately following the procedure?

A client with a history of chronic obstructive pulmonary disease (COPD) receives a new prescription for an ipratropium inhaler. Which action indicates to the nurse that additional teaching is needed?

The healthcare provider prescribes an IV solution of clindamycin 850 mg in 75 mL of DW to infuse over 30 minutes. The drop factor is 15 gtt/mL. The nurse should regulate the IV to deliver how many glt/minute? (Enler numeric value only. If rounding is required, round to the nearest whole number.)

Patient Data Exhibits What actions can the nurse do to assist the client in improving their ventilation and oxygenation? Select all that apply.

A client with cholelithiasis has a gallstone lodged in the common bile duct and is unable to eat or drink without becoming nauseated and vomiting. Which finding should the nurse report to the healthcare provider?

Patient Data

Exhibits

What order(s) would the nurse question? (Select all that apply.)