The nurse is caring for a client.
Which of the following 4 orders or prescriptions should the nurse anticipate?
Select the 4 orders or prescriptions that the nurse should anticipate.
Obtain a brain natriuretic peptide (BNP) test.
Obtain a complete blood count.
Request respiratory therapy for intubation.
Obtain a STAT MRI.
Obtain ABGs.
Prepare the client for cardiac catheterization.
Obtain a chest x-ray.
Correct Answer : A,B,E,G
A. Obtain a brain natriuretic peptide (BNP) test: BNP is a marker of heart failure and is indicated given the client’s new-onset dyspnea, crackles, and S3/S4 heart sounds. Measuring BNP helps assess for possible acute decompensated heart failure following surgery.
B. Obtain a complete blood count: A CBC helps identify infection, anemia, or other hematologic changes that could contribute to dyspnea, tachypnea, or hypoxia in the postoperative client. The client’s fever and tachycardia warrant this assessment.
C. Request respiratory therapy for intubation: Intubation is not immediately indicated as the client is still alert, maintaining oxygen saturation of 92% on supplemental oxygen. Less invasive diagnostics and interventions are prioritized first.
D. Obtain a STAT MRI: MRI is not the first-line diagnostic tool for acute dyspnea and postoperative cardiopulmonary assessment. It is not indicated in emergent evaluation of pulmonary or cardiac complications.
E. Obtain ABGs: Arterial blood gases are important to assess oxygenation, ventilation, and acid-base status given the client’s tachypnea, hypoxemia, and sudden respiratory distress.
F. Prepare the client for cardiac catheterization: Cardiac catheterization is invasive and not the immediate priority. Initial noninvasive assessment should guide the need for further intervention.
G. Obtain a chest x-ray: A chest x-ray is indicated to assess for pulmonary edema, pleural effusion, or other cardiopulmonary complications in a postoperative client presenting with dyspnea, crackles, and hypoxia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "I should lie down after my meals.": Lying down immediately after eating can worsen nausea and increase the risk of acid reflux. Clients should remain upright after meals to facilitate digestion and reduce nausea.
B. "I should avoid eating hot foods.": Avoiding hot, spicy, or strong-smelling foods can help reduce nausea and gastrointestinal discomfort. Eating bland, cool, or room-temperature foods is easier on the stomach and aligns with dietary recommendations for gastroenteritis.
C. "I should drink a caffeinated beverage one hour before a meal.": Caffeine can irritate the gastrointestinal tract and worsen nausea. Clients should avoid caffeinated beverages during episodes of gastroenteritis to prevent exacerbation of symptoms.
D. "I should increase my intake of liquids with meals.": Drinking large amounts of liquid with meals can contribute to feelings of fullness, bloating, and nausea. It is generally recommended to sip fluids between meals rather than during meals to maintain hydration without worsening symptoms.
Correct Answer is A
Explanation
A. The client started working in a parking garage 3 months ago: Working in a parking garage can increase exposure to carbon monoxide and other exhaust fumes, which can be harmful to both the pregnant client and the fetus. Prolonged inhalation of these toxins may reduce oxygen delivery and contribute to complications, making this finding a priority for further evaluation.
B. The client is doing 30 min of moderate exercise daily: Moderate exercise is recommended during pregnancy as it improves circulation, reduces stress, and supports healthy weight gain. This behavior is considered safe and beneficial unless otherwise contraindicated by the provider.
C. The client is drinking 2.5 L of water per day: Adequate hydration is essential during pregnancy to support amniotic fluid levels, circulation, and kidney function. A daily intake of 2.5 liters is appropriate and aligns with recommended guidelines for pregnant clients.
D. The client last visited the dentist 4 months ago: Routine dental care is important during pregnancy due to increased risk of gingivitis, but a dental visit 4 months ago does not indicate an unsafe behavior. Continuing regular appointments every 6 months is generally sufficient unless specific concerns arise.
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