You are caring for a patient who has Sickle Cell Disease (SCD) who is in the hospital for an acute worsening of their disease. Your patient is receiving ATC opioids for their severe pain, when they suddenly report a new sharp pain in their left shoulder. What is your BEST action?

Call the MD to report a potential Emergency

Call the MD to request a X-ray of the shoulder

Perform a head to toe assessment and then chart your findings

Call the MD to request an increase to their opioid dosage

Answer and Explanation

The Correct Answer is A

A.   A sudden new pain in a patient with SCD can be a sign of a serious complication, such as acute chest syndrome or stroke. Prompt medical evaluation is crucial to identify and address any underlying complications.
B.   While an X-ray may be helpful to rule out other causes of shoulder pain, it is not the most urgent priority in this case. The patient's sudden onset of pain could be a sign of a serious complication that requires immediate attention.
C.   While a head-to-toe assessment is important for any patient, it is not the most urgent priority in this case. The patient's new pain could be a sign of a serious complication that requires immediate medical attention.
D.   Increasing the opioid dosage may provide temporary relief from the pain, but it does not address the underlying cause of the new pain.

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Correct Answer is A

Explanation

A. This type of shock occurs when there is widespread vasodilation leading to a relative hypovolemia, often seen in conditions like sepsis. Given that the patient has a surgical site infection, this is a plausible consideration. However, distributive shock typically involves more than just hypotension, including symptoms like warm skin and possible fever.
B. This type of shock results from significant fluid loss, leading to inadequate circulating volume. It can occur after surgery due to bleeding or fluid loss, but the context here suggests that the primary issue is infection rather than direct fluid loss.
C. Obstructive shock happens when there is a physical obstruction to blood flow, such as in cases of pulmonary embolism or tension pneumothorax. There’s no indication of obstruction in this scenario related to the infection and hypotension.
D. This shock type occurs when the heart fails to pump effectively, often due to myocardial infarction or severe heart failure. The patient’s history does not suggest heart dysfunction, so this option is less likely.

A. Instructing the client to wash minor wounds carefully B. Assessing vaccination records for booster shot needs C. Teaching hand hygiene to prevent the spread of microbes D. Encouraging the client to eat a nutritious diet

Correct Answer is C

Explanation

A. Proper wound care is essential in preventing infections, particularly in older adults who may have thinner skin and slower healing processes. However, while this is important, it is just one aspect of a comprehensive infection prevention strategy and does not address broader systemic issues.
B. Older adults are often at higher risk for infections due to waning immunity. Regular vaccinations, such as the flu vaccine, pneumococcal vaccine, and others, can significantly reduce the risk of serious infections. This action is critical but is part of a preventive framework rather than a standalone solution.
C. Hand hygiene is one of the most effective measures to prevent the transmission of infections. Educating clients about proper handwashing techniques and when to wash their hands can significantly reduce the risk of infections, especially in older adults who may be more susceptible due to age-related immune changes.
D. Nutrition plays a vital role in maintaining overall health and supporting the immune system. A well- balanced diet can help older adults fight infections more effectively. However, while important, diet alone may not be as immediately impactful in preventing infections as other measures like hand hygiene and vaccination.

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You are caring for a patient who has Sickle Cell Disease (SCD) who is in the hospital for an acute worsening of their disease. Your patient is receiving ATC opioids for their severe pain, when they suddenly report a new sharp pain in their left shoulder. What is your BEST action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Your patient had an open colon resection a week ago and developed a subsequent infection of their surgical incision. Now the patient's blood pressure has been dropping for the past 2 hours and is currently 89/65. What type of shock is the patient experiencing?

Correct Answer is A

Explanation

A clinic nurse is working with an older client. What action is most important for preventing infections in this client?

Correct Answer is C

Explanation

A nurse is assessing a client who has a new diagnosis of SLE (Lupus). Which of the following findings should the nurse expect?

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