The nurse is continuing to care for the child.

Exhibits
Select the 3 priority actions that the nurse should take.

Elevate the affected forearm with pillows.

Administer Ibuprofen 200 mg PO.

Place a non adherent dressing on the right knee abrasion.

Review cast care instructions with the child's parents.

Explain the cast application procedure to the child.

Apply ice packs to the fingers and along the right forearm.

Answer and Explanation

Correct Answer : A,B,F

Rationale:
A. Elevate the affected forearm with pillows: Elevation helps reduce swelling and promotes venous return, which is critical in the immediate management of a fracture to prevent complications such as increased edema or impaired circulation.

B. Administer Ibuprofen 200 mg PO: The child reports pain at a level of 5, meeting the prescription threshold. Administering analgesia promptly helps manage discomfort and supports cooperation with further interventions, such as casting.

C. Place a nonadherent dressing on the right knee abrasion: While wound care is important, the abrasion is minor and not the most urgent concern. Prioritization focuses on the fractured limb and pain management.

D. Review cast care instructions with the child's parents: Education is important but is not the immediate priority before the cast is applied. It can be provided after the child is stabilized and pain is managed.

E. Explain the cast application procedure to the child: While preparing the child psychologically is important, immediate interventions to reduce pain and swelling take precedence over anticipatory teaching.

F. Apply ice packs to the fingers and along the right forearm: Ice helps reduce swelling and pain in the acute phase of the fracture. Applying ice in combination with elevation supports circulation and comfort while awaiting casting.

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Correct Answer is ["B","C","D","E","F","G"]

Explanation

Rationale

A. Perform a vaginal examination every 12 hr: Vaginal examinations should be avoided in a client with severe preeclampsia unless delivery is imminent, as they can stimulate uterine activity and increase the risk of placental abruption. Continuous monitoring and noninvasive assessments are prioritized instead.

B. Administer betamethasone: Betamethasone promotes fetal lung maturity by stimulating surfactant production when preterm delivery before 34 weeks is anticipated. This reduces the risk of neonatal respiratory distress syndrome and intraventricular hemorrhage.

C. Provide a low-stimulation environment: A quiet, dimly lit environment helps minimize CNS stimulation, reducing the risk of seizure activity in clients with severe preeclampsia. Environmental stressors such as bright lights and loud noises should be avoided.

D. Maintain bed rest: Bed rest, particularly in the left lateral position, improves uteroplacental perfusion and reduces blood pressure by minimizing pressure on the vena cava. It also helps limit activity that could elevate BP further.

E. Obtain a 24-hr urine specimen: Collecting a 24-hour urine specimen allows accurate assessment of total protein excretion, which confirms the severity of preeclampsia. Proteinuria greater than 300 mg/24 hr indicates significant renal involvement.

F. Give antihypertensive medication: Antihypertensives such as labetalol or hydralazine help prevent maternal complications like stroke or heart failure from sustained severe hypertension while avoiding excessive BP reduction that could impair uteroplacental blood flow.

G. Monitor intake and output hourly: Close monitoring of intake and output detects early signs of renal compromise or fluid overload, which are common in preeclampsia. Accurate measurement helps guide safe fluid management and prevent pulmonary edema.

A. 0.45% sodium chloride B. Lactated Ringer's C. 0.9% sodium chloride D. 3% sodium chloride

Correct Answer is A

Explanation

Rationale:
A. 0.45% sodium chloride: This is a hypotonic solution that helps lower elevated serum sodium levels by promoting water movement into the intracellular space. It is appropriate for correcting hypernatremia gradually while preventing cerebral edema.

B. Lactated Ringer's: Lactated Ringer’s is an isotonic solution containing sodium, potassium, and calcium. It is not ideal for hypernatremia because its sodium content can maintain or worsen elevated serum sodium levels.

C. 0.9% sodium chloride: Normal saline is isotonic and contains a high concentration of sodium, which would not reduce hypernatremia and could exacerbate the condition if used for correction.

D. 3% sodium chloride: This hypertonic solution increases serum sodium levels and is used to treat hyponatremia, not hypernatremia. Administering it to a client with hypernatremia would worsen the electrolyte imbalance.

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The nurse is continuing to care for the child. Exhibits Select the 3 priority actions that the nurse should take.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is continuing to care for the client. Exhibits The nurse is initiating the client's plan of care. Which of the following interventions should the nurse plan to implement? Select all that apply.

Correct Answer is ["B","C","D","E","F","G"]

Explanation

A nurse is caring for a client who has hypernatremia. Which of the following IV solutions should the nurse plan to administer?

Correct Answer is A

Explanation

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The nurse is continuing to care for the child.

Exhibits
Select the 3 priority actions that the nurse should take.