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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

Explanation

Choice A rationale:

The contraindication for administering clonidine in this scenario is hypertension. Clonidine is an antihypertensive medication and can lower blood pressure. If the client has hypertension, giving clonidine could exacerbate the problem and cause further reduction in blood pressure, potentially leading to complications.

Choice B rationale:

An apical heart rate of 72 beats/minute is within the normal range for adults and is not a contraindication for administering clonidine. Clonidine primarily affects blood pressure and should be used cautiously in clients with hypertension, but it does not directly impact heart rate.

Choice C rationale:

Muscle weakness is not a contraindication for administering clonidine. Clonidine is not known to cause muscle weakness as a side effect. It primarily affects blood pressure regulation.

Choice D rationale:

A blood pressure of 90/76 mm Hg is lower than the normal range for blood pressure, but it is not a contraindication for administering clonidine. In fact, clonidine is often used to lower blood pressure in hypertensive individuals. However, in this scenario, the client's low blood pressure should be carefully monitored, and the nurse should consider adjusting the clonidine dose if necessary to avoid excessive hypotension.

A. Altered level of consciousness. B. Rapid mood swings. C. Excessive motor activity. D. Failure to recognize familiar objects.

Correct Answer is D

Explanation

Choice A rationale:

An altered level of consciousness is not a typical finding in Alzheimer's disease. This condition is characterized by cognitive decline and memory impairment, but consciousness itself is not directly affected.

Choice B rationale:

Rapid mood swings can occur in individuals with Alzheimer's disease due to the changes in brain structure and function. These mood swings are a common behavioral symptom. However, the more distinctive hallmark of Alzheimer's disease is the cognitive decline rather than mood swings.

Choice C rationale:

Excessive motor activity is not a prominent feature of Alzheimer's disease. Instead, individuals with Alzheimer's disease often experience a decline in motor skills and coordination as the disease progresses.

Choice D rationale:

Failure to recognize familiar objects is a common symptom of Alzheimer's disease. This is referred to as agnosia, where individuals may struggle to recognize familiar people, objects, or places. It results from the progressive damage to brain regions responsible for memory and sensory processing.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is caring for a client who has Alzheimer's disease.Which of the following findings should the nurse expect?

Correct Answer is D

Explanation

A client is admitted with an exacerbation of heart failure secondary to chronic obstructive pulmonary disease (COPD). Which observation(s) by the nurse require immediate intervention to reduce the likelihood of harm to this client? (Select all that apply.).

When caring for an older male client with urinary frequency, which measure is most important for the nurse to implement to help the client prepare to go to bed for the night?

A nurse is teaching a client who has a urinary tract infection (UTI) about trimethoprim/sulfamethoxazole.The client asks why he needs to take two antibiotics together.What should the nurse say?

A nurse is planning recreational activities for a group of patients who are receiving rehabilitation and restorative care.Which of the following factors should the nurse consider when selecting appropriate activities? (Select all that apply.).

A client at 42-weeks gestation arrives at the labor and delivery unit for a scheduled induction but refuses the prescribed oxytocin infusion because she wants to have a "natural" delivery.Which action is most important for the nurse to implement?

The practical nurse (PN) observes an unlicensed assistive personnel (UAP) bathing a bedfast client with the bed in the high fowlers position. Which action should the PN take?

A nurse is providing education to a client prescribed an antidepressant for their phobia.Which statement by the client indicates a need for further teaching?

The mother of a child with cerebral palsy (CP) asks the nurse if her child's impaired movements will worsen as the child grows.Which response provides the best explanation?

Patient Data.

Exhibits

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