Patient Data

Exhibits

The nurse has identified the priority problem for the client and now must determine proper care interventions.

Based on the client's history and the assessment data, what action(s) should the nurse anticipate? Select all that apply.

Administer medications as ordered.

Provide client teaching.

Place the client in Trendelenburg position

Ask the client for a list of current medications.

Notify the healthcare provider of the client's need for intubation

Apply oxygen via nasal cannula

Answer and Explanation

Correct Answer : A,B,D,F

A The use of short acting beta agonists and oral steroids is key during an asthmatic attack to prevent respiratory failure.
D The nurse should also rule out the use of medications such as beta blockers which may predispose to asthmatic attack due to bronchospasms.
F Oxygen therapy should be initiated to prevent hypoxemia due to impaired ventilation. At this point, intubation may not be necessary until first line interventions have been attempted.
B Client teaching on proper inhalation technique is key. The client should also be advised on avoidance of triggers to prevent recurrence of the asthmatic attack. This, however, should be done after the client is stabilized.

Incorrect;

The Trendelenburg position is not recommended. Instead, sitting upright or in a semi-upright position can help expand the chest and improve lung expansion. This position allows the diaphragm to move more freely and can facilitate easier breathing. Leaning forward slightly may also help reduce the feeling of chest tightness.

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Correct Answer is B

Explanation

B. Sun exposure can exacerbate skin reactions such as sunburn, irritation, and even increase the risk of long-term skin damage. Therefore, advising the client to protect the area from sunlight with clothing or sunscreen helps prevent these adverse effects.
A. The ink marks used for radiation portal localization should typically remain in place throughout the course of radiation therapy to ensure accurate treatment delivery. Removing the ink marks after each treatment could potentially disrupt the treatment plan and compromise the accuracy of radiation delivery.
C. While keeping the skin moisturized is important for overall skin health, applying moisture lotions directly to the radiation portal site may not be recommended during radiation therapy.
D. Proper hygiene is important during radiation therapy, but the skin inside the radiation portal site should be cleaned gently and with care to avoid further irritation or injury.

A. Colchicine B. Naproxen C. Prednisone D. Allopurinol

Correct Answer is {"A":{"answers":"A, E"},"B":{"answers":"C, E"},"C":{"answers":"C, E"},"D":{"answers":"D, G"}}

Explanation

Colchicine is used in severe acute gout attack to minimize pain at the joint. Colchicine's mechanism of action involves interfering with the inflammatory process by binding to tubulin, a protein essential for the formation of microtubules within cells.

Prednisone is a corticosteroid with anti-inflammatory properties. It reduces inflammation caused by urate crystals.

Naproxen is a nonsteroidal anti-inflammatory drug (NSAID). It interferes with the inflammatory process in gout reducing pain. The use of naproxen and prednisone with alcohol reduces their effectiveness leading to suboptimal pain relief.

Allopurinol is a lipid lowering agent. It prevents the formation of uric acid lowering the deposition of urate crystals at the joint(s). Missing a dose of allopurinol leads to subtherapeutic blood levels and increased risk of acute gout attacks.

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Patient Data Exhibits The nurse has identified the priority problem for the client and now must determine proper care interventions. Based on the client's history and the assessment data, what action(s) should the nurse anticipate? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is receiving teletherapy radiation for a malignant tumor. Which Instruction regarding skin care of the portal site should the nurse provide?

Correct Answer is B

Explanation

Patient Data Exhibits For each medication used to treat gout, choose the most likely therapeutic outcome and the teaching associated with the medication.

Correct Answer is {"A":{"answers":"A, E"},"B":{"answers":"C, E"},"C":{"answers":"C, E"},"D":{"answers":"D, G"}}

Explanation

The nurse reviews discharge instructions with a client who has gastroesophageal reflux disease (GERD). Which instruction is most important for the nurse to emphasize?

A client is diagnosed with chronic kidney disease and needs to begin dialysis. Which condition entered on the client's medical record should the nurse recognize as a contraindication for peritoneal dialysis?

The healthcare provider prescribes penicillin 200,000 units IM for a client with pneumonia. The available vial is labeled, "Penicillin 500,000 units/mL". How many mL should the nurse administer to this client? (Enter numerical value only. If rounding is required, round to the nearest tenth.)

The nurse is performing a physical assessment of a client. Which finding should the nurse recognize is a result of a compromised peripheral arterial circulation of the lower extremity?

A client with a renal calculus reports severe right flank pain, nausea, and vomiting. Which nursing problem has the highest priority?

Patient Data Exhibits Which finding(s) in the client's health record should the nurse recognize places the client at a greater risk of developing gout? Select all that apply.

A client with stage IV bone cancer is admitted to the hospital for pain control. The client verbalizes continuous, severe pain of 8 on a 0 to 10 scale. Which intervention should the nurse implement?

Patient Data

Exhibits

The nurse has identified the priority problem for the client and now must determine proper care interventions.

Based on the client's history and the assessment data, what action(s) should the nurse anticipate? Select all that apply.