The nurse is obtaining the client's vital signs prior to an endoscopy.
Complete the following sentence by using the list of options.
The nurse should first anticipate the need to
The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}
The nurse should first anticipate the need to withhold oral intake then assess the client's vital signs.
Given the client’s symptoms of gnawing abdominal pain, dark tarry stools (indicating possible gastrointestinal bleeding), and pain worsened by eating, withholding oral intake is crucial to prevent further irritation or complications, especially before an endoscopic procedure. This helps avoid complications such as aspiration or exacerbating gastrointestinal issues. After ensuring that oral intake is managed appropriately, the nurse should then assess the client's vital signs to monitor for signs of hemodynamic instability or further deterioration, which can provide critical information about the client's current condition and guide further interventions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Incorrect. In the event of an outdoor chemical disaster, individuals should stay indoors and take shelter rather than exiting the home.
B. Incorrect. Opening the dampers of fireplaces could allow outdoor contaminants to enter the home.
C. Correct. Covering heat registers with plastic and tape can help prevent outdoor chemicals from entering the home through the ventilation system.
D. Incorrect. Turning on ceiling fans and air conditioners could potentially bring outdoor contaminants indoors through the ventilation system.
Correct Answer is D
Explanation
The correct answer is choiced. "Soiled dressings should be placed in a biohazard trash receptacle.".
Choice A rationale:
For a client who has Clostridium difficile, hand hygiene should be performed with soap and water, not an alcohol-based rub, as alcohol does not effectively kill C. difficile spores.
Choice B rationale:
Droplet precautions typically require wearing a mask, not necessarily a gown and gloves. Gown and gloves are more commonly associated with contact precautions.
Choice C rationale:
Following a blood spill, a bleach solution with a ratio of 1 to 10 is recommended, not 1 to 20. This higher concentration ensures effective disinfection.
Choice D rationale:
Placing soiled dressings in a biohazard trash receptacle is correct. This prevents the spread of infection and ensures proper disposal of contaminated materials.
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