Paugrades1479

A nurse is administering 1 L of 0.9% sodium chloride to a client who is postoperative and has fluid volume deficit. Which of the following changes should the nurse identify as an indication that the treatment was successful? Increase in hematocrit increase in respiratory rate Decrease in heart rate Decrease in capillary refill time - ANSWERSCorrect Answer: Decrease in heart rate Fluid volume deficit causes tachycardia. With correction of the imbalance, the heart rate should return to the...

A nurse is caring for a client who reports pain. When documenting the quality of the client's pain on an initial pain assessment, the nurse should record which of the following client statements? "I am having mild pain" "The pain is like a dull ache in my stomach" "I notice that the pain gets worse after I eat" "The pain makes me feel nauseous" - ANSWERS"The pain is like a dull ache in my stomach" A client in non ambulatory notifies the nurse that his trash can is on fire. A...

Exam (elaborations) HESI Fundamentals Exam Practice Questions Advanced Text 2024 2 Exam (elaborations) Fundamental HESI, Hesi Fundamentals, Hesi Fundamentals Practice Test, UNIT 1: Foundations of Nursing Practice Study Guide 2024/2025 3 Exam (elaborations) Fundamental HESI, Hesi Fundamentals, Hesi Fundamentals Practice Test, UNIT 1: Foundations

A female nurse who sometimes tries to save time by putting medications in her uniform pocket to deliver to clients, confides that after arriving home she found a hydrocodone (Vicodin) tablet in her pocket. Which possible outcome of this situation should be the nurse's greatest concern? A.) Accused of diversion. B.) Reported for stealing. C.) Reported for a HIPAA violation. D.) Accused of unprofessional conduct. - ANSWERSA Rationale: Even if this is only one incident, the nurse may be s...

Which assessment data would provide the most accurate determination of proper placement of a nasogastric tube? A) Aspirating gastric contents to assure a pH value of 4 or less. B) Hearing air pass in the stomach after injecting air into the tubing. C) Examining a chest x-ray obtained after the tubing was inserted. D) Checking the remaining length of tubing to ensure that the correct length was inserted. - ANSWERSC) Examining a chest x-ray obtained after the tubing was inserted Both ...

Which assessment data would provide the most accurate determination of proper placement of a nasogastric tube? A) Aspirating gastric contents to assure a pH value of 4 or less. B) Hearing air pass in the stomach after injecting air into the tubing. C) Examining a chest x-ray obtained after the tubing was inserted. D) Checking the remaining length of tubing to ensure that the correct length was inserted. - ANSWERSC) Examining a chest x-ray obtained after the tubing was inserted Both ...

The nurse observes that a male client has removed the covering from an ice park applied to his knee. What action should the nurse take first? A. Observe the appearance of the skin under the ice pack. B. Instruct the client regarding the need for the covering. C. Reapply the covering after filling with fresh ice. D. Ask the client how long the ice was applied to the skin. - ANSWERSObserve the appearance of the skin under the ice pack (The first action taken by the nurse should be to assess t...

1. Older female client can't sleep at night. Nurse recommends SATA A. Take afternoon nap B. Ask HCP for prescription of mild sedative at bedtime C. Establish regular time for getting up and going to bed D. Drink whiskey, water and honey before bed E. Avoid drinking caffeine before bedtime - ANSWERSAns: C, E 2. The nurse has been alerted by the EMR when scanning the dispensed medication that the dosage is two times higher than the prescribed dose. The nurse should: A. Report mismatch of...

a 35 year old female client with cancer refuses to allow the nurse to insert an IV for a scheduled chemotherapy treatment, and states that she is ready to go home and die. What intervention should the nurse initiate? A. evaluate the client's mental status for competence to refuse treatment B. review the client's medical record for an advance directive C. determine if a DNR prescription has been obtained D. document that the client is being discharged against medical advice - ANSWERSA. eva...

When turning an immobile bedridden client without assistance, which action by the nurse best ensures client safety? A. Securely grasp the client's arm and leg. B. Put bed rails up on the side of bed opposite from the nurse. C. Correctly position and use a turn sheet. D. Lower the head of the client's bed slowly. - ANSWERSB Rationale: Because the nurse can only stand on one side of the bed, bed rails should be up on the opposite side to ensure that the client does not fall out of bed. Opti...