RN Adult Medical Surgical Online Practice 2023 A NGN, Answered
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RN Adult Medical Surgical Online Practice 2023 A NGN, Answered-NGN 1000: Client is alert and oriented and reports not feeling well for a few days. Client is on continuous ambulatory peritoneal dialy sis (CAPD) and reports dialysate appeared cloudy this morning. Reports abdominal pain as 4 on a scal...
rn adult medical surgical online practice 2023 a n
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RN Adult Medical Surgical Online Practice
2023 A NGN, Answered
NGN
1000:
Client is alert and oriented and reports not feeling well for a few days. Client is on continuous
ambulatory peritoneal dialysis (CAPD) and reports dialysate appeared cloudy this morning.
Reports abdominal pain as 4 on a scale of 0 to 10.
Bowel sounds active in all quadrants.
Peritoneal dialysis access site red, warm to touch, with a small amount of purulent drainage
noted on dressing.1300:
Client is lying in bed with the knees flexed, guarding the abdomen. Abdomen is slightly distende
- The client is experiencing manifestations of Peritonitis due to x-ray results
.
NGN
Client admitted to medical-surgical unit from PACU. Client reports incisional pain as 2 on a
scale of 0 to 10. Client appears restless and frequently asks for water. Bilateral lower extremities
cool with +1 pedal pulses. Urine output is 40 mL for the past 2 hr. Moderate amount of bright
red drainage noted on surgical incision dressing. - Insert a large-gauge IV.
Initiate a fluid challenge.
Hypovolemia
Urine output
Blood pressure
A nurse is caring for a client who has a potassium level of 3 mEq/L. Which of the following
assessment findings should the nurse expect? - Hypoactive Bowel Sounds
NGN
0900:
Client presents with abdominal pain in the upper left quadrant for the past 2 days. States pain
became worse this morning and is radiating to the back. Rates pain as 8 on a scale of 0 to 10.
Hypoactive bowel sounds; reports nausea, no vomiting; client is passing flatus.
Febrile, oriented to person, place, and time.
Tachypnea with diminished breath sounds.
Sinus tachycardia.
Client voids 300 mL of clear, amber urine.
0930:
Client vomited 100 mL brown liquid. - The client is experiencing manifestations of
pancreatitis
as evidenced by the
amylase and lipase
, .
0530:
Client is awake and alert.
Arteriovenous fistula (AVF) to right forearm with thrill palpated and auscultated for bruit. Lung
sounds clear upon auscultation; client denies shortness of breath. No peripheral edema noted;
capillary refill is less than 3 seconds; +2 bilateral pedal and radial pulses.
AVF access prepared and cannulated twice with no difficulty. Lines are taped and secured;
treatment is initiated.0600:
Client is reading a book. Access is visible, and lines are secure. Client rep - Perform a 12-lead
ECG is not indicated.
Place the client in Trendelenburg position is indicated.
Administer a 0.9% sodium chloride 200 mL IV bolus is indicated.
Apply oxygen at 2 L/min via nasal cannula is indicated
Notify the provider immediately is indicated
Obtain the client's blood glucose level is not indicated.
1800:
Emergency medical team removed client's shirt at the scene and initiated 18-gauge IV therapy in
the right antecubital space.
Client has full-thickness burns over the upper half of the chest and both forearms; partial-
thickness burns are present on the client's face and neck.
Sinus tachycardia, pulses to brachial extremities palpable. 1+ edema to upper extremities.
Respirations even, labored with scattered rhonchi. Soot noted to the client's mouth and nose.
Oxygen 40% via face tent applied. - During the emergent phase of burn care, the client is at risk
for developing
hypovolemia
and
respiratory failure
.
A nurse is teaching a class about client rights. Which of the following instructions should the
nurse include? - A client should sign an informed consent before receiving a placebo during a
research trial.
A nurse in an emergency department is caring for a client who reports vomiting and diarrhea for
the past 3 days. Which of the following findings should indicate to the nurse that the client is
experiencing fluid volume deficit? - Heart rate 110/min
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