Patient Profile:

Name: Mr. John Smith

Age: 68 years

Medical History: Osteoarthritis of the hip, Type 2 diabetes, hypertension, and atrial fibrillation

Current Medications: Lisinopril, Metformin, Warfarin

Surgical Procedure: Total hip replacement (THR) due to severe pain and limited mobility.

Preoperative Care:

The nurse conducts a comprehensive assessment, including a physical examination, vital signs, and a review of Mr. Smith's medical history.

Preoperative labs are ordered with the following abnormal values noted:

Complete Blood Count (CBC):

Hemoglobin: 12.0 g/dL (normal range: 13.5-17.5 g/dL)

Hematocrit: 36% (normal range: 38.8-50%)

Basic Metabolic Panel (BMP):

Serum Creatinine: 3 mg/dL (normal range: 0.6-1.2 mg/dL)

Blood Urea Nitrogen (BUN): 24 mg/dL (normal range: 7-20 mg/dL)

Coagulation Studies:

INR: 5 (normal range: 0.8-1.1)

Intraoperative Care:

The scrub nurse assists in positioning Mr. Smith on the operating table.

During the post-op period, what four potential complications should be monitored?

Dementia

VTE

Fluid overload

Infection

Unrelieved pain

Answer and Explanation

Correct Answer : B,C,D,E

Choice A reason: Dementia is not a typical complication directly related to the post-operative period of a total hip replacement. While elderly patients may have underlying cognitive issues, dementia is not considered a direct post-op complication.

Choice B reason: Venous thromboembolism (VTE) is a common post-operative complication, particularly in orthopedic surgeries like total hip replacement. Due to immobility and surgical stress, patients are at higher risk for blood clots forming in the veins, which can be life-threatening if they travel to the lungs.

Choice C reason: Fluid overload can occur due to the administration of intravenous fluids during surgery. Monitoring for signs of fluid overload, such as swelling, shortness of breath, and increased blood pressure, is crucial to ensure proper fluid balance and prevent complications like heart failure.

Choice D reason: Infection is a significant risk after surgery, especially in procedures like total hip replacement. Monitoring for signs of infection, such as fever, increased pain, redness, swelling, and drainage from the surgical site, is essential to detect and treat infections early.

Choice E reason: Unrelieved pain is a critical aspect to monitor post-operatively. Effective pain management is crucial for patient comfort, mobility, and recovery. Uncontrolled pain can impede rehabilitation and recovery, increasing the risk of complications.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

Choice A reason: Fluid volume overload is not typically associated with diabetes insipidus. Instead, patients with diabetes insipidus often experience fluid volume deficit due to excessive urine output.

Choice B reason: Hyperglycemia is not a characteristic problem of diabetes insipidus. This condition involves an imbalance in water regulation due to insufficient production or response to antidiuretic hormone (ADH), rather than issues related to blood glucose levels.

Choice C reason: Nocturia, or frequent urination at night, is a common problem in diabetes insipidus. Patients with this condition produce large amounts of dilute urine, which can lead to frequent nighttime urination.

Choice D reason: Generalized edema is not a typical problem in diabetes insipidus. Edema is more commonly associated with conditions involving fluid retention, such as heart failure or kidney disease, rather than the excessive fluid loss seen in diabetes insipidus.

A. Nursing supervisor B. Registered nurse (RN) C. Health care provider (MD/NP) D. Licensed practical/vocational nurse (LPN/VN)

Correct Answer is B

Explanation

Choice A reason: Nursing supervisors generally oversee nursing staff and ensure that patient care standards are being met, but they are not primarily responsible for developing individualized plans of care.

Choice B reason: Registered nurses (RNs) are trained and licensed to develop individualized plans of care that include nursing diagnoses, interventions, and outcomes. They work closely with patients to understand their needs and create a plan that supports their health goals, including self-management care.

Choice C reason: Health care providers, such as medical doctors (MDs) or nurse practitioners (NPs), are responsible for diagnosing and treating medical conditions, but the development of detailed nursing care plans is typically outside their primary scope of practice.

Choice D reason: Licensed practical/vocational nurses (LPN/VN) provide basic nursing care and assist with patient care activities, but they do not generally develop comprehensive nursing care plans, which require the higher level of training and education that RNs receive.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which problem should the nurse anticipate for a patient admitted to the hospital with diabetes insipidus?

Correct Answer is C

Explanation

In any clinical setting, which health care team member is responsible for developing an individualized plan of care that includes nursing diagnoses, interventions, and outcomes, including the patient's self-management care plan?

Correct Answer is B

Explanation

A patient who has been treated for status epilepticus in the emergency department will be transferred to the medical nursing unit. Which equipment should the nurse have available in the patient's assigned room? (Select all that apply)

A patient with sickle cell disease has developed cellulitis above the left ankle. Which action is the nurse's priority for this patient?

When caring for a patient with Alzheimer's disease, the nurse would assess the patient for which two common infection-related complications due to chronic dementia?

Which patient statement indicates to the nurse that additional instruction is needed for a patient with chronic syndrome of inappropriate antidiuretic hormone (SIADH)?

Which outcome would the nurse include in the care plan for a patient with multiple sclerosis (MS)? Select all that apply.

After reviewing the laboratory reports of a patient who was admitted with sudden severe abdominal pain, the nurse identifies that which condition is consistent with the test results?

When a patient with asthma who is on a budesonide hand-held inhaler reports difficulty, what should the nurse do?