The nurse receives a telephone prescription from the healthcare provider for a client's persistent cough and wheezing. The prescription includes a chest x-ray, an antibiotic, and a nebulizer treatment now and as needed (PRN). After reading the prescription back to the healthcare provider to ensure accuracy, which intervention should the nurse implement first?
Apply portable oxygen for transport to radiology.
Administer a nebulizer breathing treatment.
Evaluate breathing pattern.
Start the prescribed antibiotic.
The Correct Answer is B
Choice A rationale: Applying portable oxygen for transport to radiology is not the first priority. The immediate concern is assessing and addressing the client's respiratory distress before initiating specific interventions.
Choice B rationale: The nebulizer treatment should be administered FIRST to alleviate the clients obstructed airway (respiratory distress)
Choice C rationale: Evaluating the breathing pattern is important but should be done immediately after implementing physician orders
Choice D rationale: Starting the prescribed antibiotic is not the first priority. Respiratory assessment takes precedence to address the client's immediate distress.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: This statement is inaccurate. Managed healthcare plans typically cover in-hospital medical evaluations, but the decision may be subject to precertification requirements.
Choice B rationale: While grief is a natural response to the loss of a spouse, the client's confusion and disorientation warrant a medical evaluation, and this option dismisses the family's concerns.
Choice C rationale: Managed care providers often have mandatory precertification requirements for hospitalization. Informing the family about this requirement is important for them to navigate the process effectively.
Choice D rationale: This statement does not provide relevant information about the managed healthcare plan's policies or the client's current condition.
Correct Answer is B
Explanation
Choice A rationale: While a history of vomiting at home for 3 days prior to surgery may be relevant, the information provided by the PACU nurse already includes the time of the last administration of nausea medications, making this option less critical at this moment.
Choice B rationale: Providing information about the abdomen, bowel sounds, and the absence of bleeding on the dressing is essential for assessing the postoperative condition of the client. It gives the receiving nurse a comprehensive overview of the client's immediate status following surgery.
Choice C rationale: Refusal to take ice chips for complaints of dry mouth is relevant to the client's comfort and hydration but may not be as critical as assessing surgical outcomes and complications.
Choice D rationale: Information about peripheral pulses and the range of motion of both legs is important but may be more pertinent to the neurological and circulatory assessment rather than immediate postoperative concerns. The surgical site and abdominal assessment are more directly related to the recent laparotomy.
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