The practical nurse (PN) is planning evening shift rounds for a group of postoperative clients who all had surgery earlier that day. Which client should the PN check first?
A preschooler who had an emergency appendectomy for appendicitis.
An adult with osteomyelitis who had a necrotic bone fragment removed in the foot.
A post-menopausal client with breast cancer who had a right breast lumpectomy.
An adolescent with type 1 diabetes (DM) who had an open cholecystectomy.
The Correct Answer is A
A. A preschooler who had an emergency appendectomy should be checked first. Children are at higher risk for complications due to their size and the stress of emergency surgery, so close monitoring is essential.
B. An adult with osteomyelitis post-surgery is important to monitor but is generally at lower immediate risk compared to a young child following emergency surgery.
C. A post-menopausal client with breast cancer who had a lumpectomy is also a priority, but the immediate postoperative period for a child in emergency surgery takes precedence.
D. An adolescent with type 1 diabetes who had cholecystectomy requires careful monitoring, but the child’s higher risk in the immediate postoperative phase makes them the priority.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Changing gloves is important for infection control, but in this context, the main issue is with the technique being used for the client's feet.
B. Soaking the feet is not recommended for clients with diabetes due to the risk of skin damage and infection; it is better to wash the feet gently and inspect them regularly.
C. Checking the client’s feet is important but should be done before washing or soaking, and the main concern here is not to soak the feet at all.
D. While testing water temperature is crucial for safe bathing, the more pressing issue here is the method of foot care for a diabetic client, which is not to soak the feet
Correct Answer is ["0.6"]
Explanation
- Medication dose: 30 mg enoxaparin
- Medication concentration: 30 mg per 0.3 mL (prefilled syringe)
- Frequency: Every 12 hours
- Duration: 10 days
Calculation:
- Injections per day: Since the medication is given every 12 hours, the client will receive injections 2 times per day (24 hours / 12 hours/injection).
- Total medication per day: To find the total amount of enoxaparin needed per day, multiply the single injection dose by the number of injections:
Total enoxaparin/day = Dose per injection x Number of injections/day = 30 mg/injection x 2 injections/day = 60 mg/day
- Volume of medication per day: Now, we need to find the volume of solution needed to deliver the total daily dose (60 mg) based on the medication concentration (30 mg/0.3 mL). We can achieve this with a proportion:
Volume (mL) / Total dose (mg) = Concentration (mg/mL)
Volume (mL) = (Total dose (mg) x Concentration (mL/mg)) / Concentration (mg/mL)
Plugging in the values:
Volume (mL) = (60 mg x 0.3 mL/mg) / 30 mg/mL
Volume (mL) = 18 mL / 30 mL/mL
Simplifying:
Volume (mL) = 0.6 mL
Therefore, the practical nurse (PN) should administer 0.6 mL of enoxaparin each day.
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