An adult woman with primary Continue to monitor the fingers until color returns to normal
Raynaud phenomenon develops
pallor and then cyanosis of her
fingers. After warming her hands,
the fingers turn red and the client
reports a burning sensation. What
action should the nurse take?
A. Apply a cool compress to the
affected fingers for 20 minutes
B. Secure a pulse oximeter to
monitor the client's oxygen
saturation
C. Report the finding to the
healthcare provider as soon as
possible
D. Continue to monitor the fingers
until color returns to normal
,After a CT scan with intravenous Prepare a dose of epinephrine
contrast medium, a client returns to
the room complaining of shortness
of breath and itching. Which
intervention should the nurse
implement?
A. Call respiratory therapy to give a
breathing treatment.
B. Send another nurse for
emergency tracheostomy set
C. Prepare a dose of epinephrine
D. Review the clients complete list
of allergies
After hospitalization for SIADH, a Reorient client to room
client develops pontine
myelinolysis. Which intervention
should the nurse implement first?
A. Reorient client to room
B. Place a patch on one eye
C. Evaluate clients ability to swallow
D. Perform range of motion
exercises
,A cardiac catherization of a client Three main arteries have major blockages, with only 1-5% of the blood
with heart disease indicates the flow getting through to the heart muscles
following blockages: 95% proximal
left anterior descending (LAD), 99%
proximal circumflex, and 95%
proximal right coronary artery
(RCA) the client later asks the nurse
"What does all of that mean for me?"
What information should the nurse
provide.
B. Three main arteries have major
blockages, with only 1-5% of the
blood flow getting through to the
heart muscles
, A client being admitted to a surgical Elevate head of bed to 60 to 90 degrees
unit is being evaluated for an
intestinal obstruction. The HCP
prescribes a NG tube to be inserted
and placed to intermittent low wall
suction. which intervention should
the nurse implement to facilitate
proper tube placement.
A. Soak NG tube in warm water
B. Insert tube with clients head tilted
back
C. Apply suction while inserting
tube
D. Elevate head of bed to 60 to 90
degrees
A client who has a history of Further decline in LOC
hyperthyroidism was initially
admitted with lethargy and
confusion. Which additional finding
warrants the most immediate action
by the nurse?
A. Facial puffiness and periorbital
edema
B. Hematocrit of 30%
C. cold and dry skin
D. Further decline in LOC
Raynaud phenomenon develops
pallor and then cyanosis of her
fingers. After warming her hands,
the fingers turn red and the client
reports a burning sensation. What
action should the nurse take?
A. Apply a cool compress to the
affected fingers for 20 minutes
B. Secure a pulse oximeter to
monitor the client's oxygen
saturation
C. Report the finding to the
healthcare provider as soon as
possible
D. Continue to monitor the fingers
until color returns to normal
,After a CT scan with intravenous Prepare a dose of epinephrine
contrast medium, a client returns to
the room complaining of shortness
of breath and itching. Which
intervention should the nurse
implement?
A. Call respiratory therapy to give a
breathing treatment.
B. Send another nurse for
emergency tracheostomy set
C. Prepare a dose of epinephrine
D. Review the clients complete list
of allergies
After hospitalization for SIADH, a Reorient client to room
client develops pontine
myelinolysis. Which intervention
should the nurse implement first?
A. Reorient client to room
B. Place a patch on one eye
C. Evaluate clients ability to swallow
D. Perform range of motion
exercises
,A cardiac catherization of a client Three main arteries have major blockages, with only 1-5% of the blood
with heart disease indicates the flow getting through to the heart muscles
following blockages: 95% proximal
left anterior descending (LAD), 99%
proximal circumflex, and 95%
proximal right coronary artery
(RCA) the client later asks the nurse
"What does all of that mean for me?"
What information should the nurse
provide.
B. Three main arteries have major
blockages, with only 1-5% of the
blood flow getting through to the
heart muscles
, A client being admitted to a surgical Elevate head of bed to 60 to 90 degrees
unit is being evaluated for an
intestinal obstruction. The HCP
prescribes a NG tube to be inserted
and placed to intermittent low wall
suction. which intervention should
the nurse implement to facilitate
proper tube placement.
A. Soak NG tube in warm water
B. Insert tube with clients head tilted
back
C. Apply suction while inserting
tube
D. Elevate head of bed to 60 to 90
degrees
A client who has a history of Further decline in LOC
hyperthyroidism was initially
admitted with lethargy and
confusion. Which additional finding
warrants the most immediate action
by the nurse?
A. Facial puffiness and periorbital
edema
B. Hematocrit of 30%
C. cold and dry skin
D. Further decline in LOC
