The nursing assessment finding that represents the most serious indication of a client's deteriorating oxygenation status is:

pursed-lip breathing.

clubbing of the nails.

cyanosis.

poor skin turgor.

Answer and Explanation

The Correct Answer is C

Choice A rationale: Pursed-lip breathing is a compensatory mechanism to improve oxygenation and is not as severe an indication as cyanosis.

Choice B rationale: Clubbing of the nails is a chronic sign of oxygenation issues but may not be an acute and immediate indication of deterioration.

Choice C rationale: Cyanosis, the bluish discoloration of the skin and mucous membranes, is a serious indication of inadequate oxygenation.

Choice D rationale: Poor skin turgor is not a direct indicator of oxygenation status.

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Correct Answer is A

Explanation

Choice A rationale: An inflammatory response, including mild fever and malaise, is common during the inflammatory phase of healing, which occurs in the initial postoperative period.

Choice B rationale: Proliferation is the phase of healing characterized by tissue repair and regeneration, not by fever and malaise.

Choice C rationale: Remodeling is the final phase of healing involving tissue maturation and strengthening, not associated with generalized body responses.

Choice D rationale: Infection is a separate complication and may present with more severe symptoms than mild fever and malaise.

A. Shared responsibility B. Mutual independence C. Working in the same department D. Common purpose

Correct Answer is C

Explanation

Choice A rationale: Shared responsibility is a necessary feature of a team, promoting collaboration and achievement of common goals.

Choice B rationale: Mutual independence allows team members to work together while maintaining individual contributions.

Choice C rationale: Working in the same department is not a necessary feature of a team. Teams can be effective regardless of their physical proximity.

Choice D rationale: Common purpose is essential for a team to work cohesively toward shared goals.

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The nursing assessment finding that represents the most serious indication of a client's deteriorating oxygenation status is:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client has had an uncomplicated repair of an inguinal hernia. On the second post- operative day, the client has mildly elevated temperature and general malaise. The nurse recognizes that this is a generalized body response which is common to which phase of healing?

Correct Answer is A

Explanation

The nurse recognizes that which is not a necessary feature of a team?

Correct Answer is C

Explanation

The nurse recognizes ten "rights" associated with giving medications to clients. Which are included in this group? (SELECT ALL THAT APPLY)

The client has an open wound on the sacrum with an order for the following: "Apply hydrogel dressing on the wound. Change dressing every day." The nurse recognizes that the primary purpose of this dressing is to:

The client has had a surgical debridement of a wound, which is starting to heal. In order to further promote healing, this client should be encouraged to consume a balanced diet with emphasis on increased:

The nursing assessment finding that represents the most serious indication of a client's deteriorating oxygenation status is:

A client has a serum potassium level of 6.3 mEq/L. The nurse recognizes that the highest priority intervention(s) for this client are to: (SELECT ALL THAT APPLY)

In order to minimize discomfort when giving an injection to a client, the nurse should:

Which one of the following blood levels would provide the nurse with the most information about the ability of the client's blood to transport oxygen? The: