The nurse receives a patient from the emergency department following administration of a fibrinolytic medication, TPA, for a large anterior wall myocardial infarction. The priority assessment for this patient would be which of the following?
Urine output
Vital signs
Name of the patient's dog
Neurological status
The Correct Answer is D
Choice A reason: Urine output is important but not the priority after administration of fibrinolytic medication.
Choice B reason: Vital signs are routinely monitored but the priority is assessing for any signs of complications from the medication, such as bleeding or stroke.
Choice C reason: The name of the patient's dog is irrelevant to the patient's medical care and assessment.
Choice D reason: Neurological status is the priority to monitor for signs of intracranial hemorrhage, a potential complication of fibrinolytic therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Lactated Ringer's solution does not provide the necessary glucose and may not be compatible with TPN.
Choice B reason: 0.45% sodium chloride (0.45% NaCl) is a hypotonic solution and does not provide adequate calories for a patient on TPN.
Choice C reason: 10% dextrose in water (D10W) is the appropriate choice as it provides a source of calories and prevents hypoglycemia until the next TPN bag is available.
Choice D reason: 5% dextrose in lactated Ringer's solution (D5LR) provides less dextrose than D10W and may not prevent hypoglycemia as effectively.
Correct Answer is D
Explanation
Choice A reason: Avoiding tanning booths is correct and does not indicate a need for further teaching.
Choice B reason: Using sunscreen even on cloudy days is correct and does not indicate a need for further teaching.
Choice C reason: Checking the skin monthly for any changes is correct and does not indicate a need for further teaching.
Choice D reason: The statement about eating a high-fiber diet reducing the risk for developing skin cancer indicates a misunderstanding, as there is no direct correlation between a high-fiber diet and the prevention of skin cancer. This indicates a need for further teaching.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.