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Patient Data.

Exhibits

Which order would the nurse question? Select all that apply.

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

Enalapril 10 mg every morning.

Supplemental oxygen 10 L/min via nasal cannula.

Continuous pulse oximetry.

Send blood for a complete blood count, electrolytes, blood cultures, and procalcitonin.

Admit to the medical floor.

Vital signs every 4 hours.

Chest x-ray now.

Sputum culture and sensitivity.

Levofloxacin 500 mg intravenously every 24 hours.

Answer and Explanation

Correct Answer : A,B,C

Choice A rationale:

Ibuprofen 400 mg every 4 to 6 hours as needed for temperature greater than 100.5 °F (38 °C). This order is questionable because ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can potentially increase blood pressure, which could be harmful to a patient with hypertension. Furthermore, NSAIDs can mask the symptoms of infection, which could delay the diagnosis and treatment of serious infections.

Choice B rationale:

Enalapril 10 mg every morning. This order is questionable because enalapril is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension. However, ACE inhibitors can cause a dry cough, which could exacerbate the patient’s existing cough due to pneumonia. Additionally, ACE inhibitors can potentially cause hyperkalemia (high potassium levels), so it’s important to monitor the patient’s electrolyte levels.

Choice C rationale:

Supplemental oxygen 10 L/min via nasal cannula. This order is questionable because a high flow rate of oxygen can potentially cause oxygen toxicity or hyperoxia, which can lead to cellular damage. The typical flow rate for a nasal cannula is between 1-6 L/min. A flow rate of 10 L/min may be too high for this patient, especially without a specified target SpO2 range.

Choice D rationale:

Continuous pulse oximetry. This order is appropriate because it allows for continuous monitoring of the patient’s oxygen saturation levels, which is crucial in a patient with pneumonia and shortness of breath.

Choice E rationale:

Send blood for a complete blood count, electrolytes, blood cultures, and procalcitonin. This order is appropriate because these tests can help monitor the patient’s overall health status and response to treatment.

Choice F rationale:

Admit to the medical floor. This order is appropriate because the patient requires hospitalization for treatment and monitoring due to his pneumonia.

Choice G rationale:

Vital signs every 4 hours. This order is appropriate because it allows for regular monitoring of the patient’s vital signs, which can help detect any changes in his condition.

Choice H rationale:

Chest x-ray now. This order is appropriate because a chest x-ray can help confirm the diagnosis of pneumonia and assess its severity.

Choice I rationale:

Sputum culture and sensitivity. This order is appropriate because it can help identify the specific organism causing the pneumonia and determine its antibiotic sensitivity, which can guide antibiotic therapy.

Choice J rationale:

Levofloxacin 500 mg intravenously every 24 hours. This order is appropriate because levofloxacin is a broad-spectrum antibiotic commonly used to treat pneumonia.

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Correct Answer is ["A","C","D","E"]

Explanation

Choice A rationale:

Verapamil is a calcium channel blocker and is expected to decrease heart rate by inhibiting calcium influx into cardiac cells, particularly in the SA (sinoatrial) node, where it can slow down the heart's electrical impulses.

Choice B rationale:

Increased contractility is not an expected outcome of verapamil use. In fact, verapamil's main action is to decrease myocardial contractility, making it useful for treating conditions like angina and atrial fibrillation.

Choice C rationale:

Verapamil is known to dilate coronary arteries, which can improve blood flow to the heart muscle and relieve symptoms of angina.

Choice D rationale:

Reduced blood pressure is an expected outcome of verapamil use due to its vasodilatory effects on peripheral blood vessels. This can be beneficial in treating hypertension and angina.

Choice E rationale:

Relieved chest pain is an expected outcome of verapamil use, particularly in the case of variant angina (Prinzmetal's angina), as it helps to relax coronary arteries and reduce coronary artery spasm, which is a common cause of chest pain in this condition.

A. Gather information regarding how long it will take for the children to arrive. B. Explain that the client will start to lose consciousness and the body systems will slow down. C. Offer to discuss the client's health status with each of the adult children. D. Reassure the spouse that the healthcare provider will notify when to call the children.

Correct Answer is B

Explanation

Choice B rationale:

Choice A rationale:

Gathering information regarding how long it will take for the children to arrive is important but does not address the immediate need for information on the dying process.

Choice C rationale:

Offering to discuss the client's health status with each of the adult children is a good approach for involving them in their father's care but does not provide the immediate information the wife is seeking.

Choice D rationale:

Reassuring the spouse that the healthcare provider will notify when to call the children does not offer information about the dying process itself, which is what the wife is interested in understanding.

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Patient Data. Exhibits Which order would the nurse question? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has variant angina and is prescribed verapamil.Which of the following are expected outcomes of this medication? (Select all that apply.)

Correct Answer is ["A","C","D","E"]

Explanation

An adult male was diagnosed with stage IV lung cancer three weeks ago.His wife approaches the nurse and asks how she will know that her husband's death is imminent because their two adult children want to be there when he dies.Which is the best response by the nurse?

Correct Answer is B

Explanation

The practical nurse (PN) believes that a prescription for a child is incorrect because the dosage prescribed is the usual adult dosage. Which action should the PN take?

A nurse is caring for a client who has meningitis caused by Streptococcus pneumoniae.The provider orders penicillin G IV for this client.Before administering the medication, which of the following actions should the nurse take?

A 5-year-old child with a history of a waddling gait and frequent falls is brought into the hospital for diagnostic testing.When explaining the diagnostic testing to the parents, the nurse should provide information based on which understanding of the underlying disease pathology?

A nurse is teaching a group of nursing students about the components of critical thinking.Which of the following statements by a student indicates a need for further teaching?

The healthcare provider prescribes the antibiotic cefdinir 300 mg by mouth every 12 hours for a client with a postoperative wound infection.Which foods should the nurse encourage this client to eat?

A client who weighs 176 pounds receives a prescription for norepinephrine 2 mcg/min intravenously (IV). The IV bag is labeled, "Norepinephrine 4 mg in dextrose 5% in water (D; W) 1,000 mL." How many mL/hour should the nurse program the infusion pump? (Enter numerical value only.).

After a client receives a dose of albuterol, the nurse evaluates the medication's effects by auscultating the client's lung fields. Which action should the nurse take next based on the assessment?

A client with chronic kidney disease receives a prescription for darbepoetin alfa 40 mcg subcutaneous every 7 days. The darbepoetin alfa vial is labeled, "60 mcg/mL." How many mL should the nurse administer?

Patient Data.

Exhibits

Which order would the nurse question? Select all that apply.