Patient Data
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
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
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["38"]
Explanation
Drop rate (gtt/min) = Volume to be infused (mL)/ Time of infusion (minutes) × Drop factor (gtt/mL)
Given:
Volume to be infused (V) = 75 mL Time of infusion (T) = 30 minutes Drop factor = 15 gtt/mL
Using the formula:
Drop rate (gtt/min)= [75/30]*15 Drop rate (gtt/min)=2.5×15
Drop rate (gtt/min)=37.5
Rounding to the nearest whole number, the nurse should regulate the IV to deliver approximately 38 gtt/minute.
Correct Answer is B
Explanation
B. Pancreatitis is often associated with elevated serum amylase levels due to pancreatic inflammation. Therefore, this combination of clinical symptoms and laboratory findings is valuable in assessing the severity and confirming the diagnosis of pancreatitis.
A. While these are important clinical findings, they are not specific to pancreatitis and may not provide definitive information about the severity or cause of the condition.
C. Chronic constipation and serum gastrin levels are not typically associated with pancreatitis.
D. Serum Helicobacter pylori (H. pylori) antibody results and urine output amounts are not directly related to pancreatitis. H. pylori infection is associated with peptic ulcers and gastritis but not typically with pancreatitis.
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