ATI Comp Practice B W-NGN Exam

ATI Comp Practice B W-NGN Exam A nurse is caring for a client who is 1 day postoperative following a total thyroidectomy. Laboratory Results 0700: Sodium 143 mEq/L (136 to 145 mEq/L) Potassium 3.5 mEq/L (3.5 to 5 mEq/L) Chloride 104 mEq/L (98 to 106 mEq/L ) BUN 15 mg/dl (10 to 20 mg/dl) Magnesium 1.5 mEq/L (1.3 to 2.1 mEq/L ) Total calcium 8 mg/dL (9 to 10.5 mg/dL) Phosphate 4.6 mg/dL (3 to 4.5 mg/dL) Glucose 95 mg/dL (74 to 106 mg/dL) WBC 9,500/mm3 (5,000 to 10,000/mm3) Nurses' Notes 0700: Client alert and oriented to person, place, and time. Respirations even and unlabored with no adventitious sounds. Bowel sounds active in all 4 quadrants. Surgical dressing dry, slight edema at incision site noted. Client rates dull pain in neck of 2 on a 0 to 10 scale. Declines pain medication. 1100: Client alert and oriented to person, place, and time. Respirations even and unlabored with no adventitious sounds. Bowel sounds active in all 4 quadrants. Surgical dressing dry, slight edema at incision site noted. Client reports muscle cramps in legs as a pain level of 5 on a 0 to 10 scale. Morphine 5 mg IV administered. Encouraged client to ambulate with assistance. 1200: Client alert and oriented to person, place, and time. Respirations even and unlabored with no adventitious sounds. Bowel sounds active in all 4 quadrants. Surgical dressing dry, slight edema at incision site noted. Client ambulated down the hall with assistance. Client reports numbness around lips. Vital Signs 0700: Temperature 37.6° C (99.6° F) Heart rate 65/min Respiratory rate 16/min Blood pressure 115/70 mm Hg Oxygen saturation 98% on room air 0900: Temperature 37.2° C (99° F) Heart rate 72/min Respiratory rate 18/min Blood pressure 110/72 mm Hg Oxygen saturation 100% on room air 1100: Temperature 37.7° C (99.9° F) Heart rate 76/min Respiratory rate 16/min Blood pressure 108/70 mm Hg Oxygen saturation 100% on room air Medication Administration Record 1100: 0.9% Sodium chloride at 150 mL/hr Morphine sulfate 5 mg IV - ANSWER The client is at highest risk for developing hypocalcemia as evidenced by the report of numbness around lips. A nurse is caring for a client who has abdominal pain. Nurses' Notes 0900: Client reports loss of appetite, weight loss, and fatigue for 1 week. Reports abdominal pain, 6 on a scale from 0 to 10, for 2 days. Client is a perioperative nurse, returned 1 week ago from a 2-week mission trip to an underdeveloped country. 1200: Results of antibody studies obtained. Provider prescription for antiviral medication pending. Physical Examination 0930: Lung sounds clear bilaterally. Skin warm to touch and jaundiced. Dry skin noted on extremities. Sclera yellow bilaterally. Bowel sounds normoactive in four quadrants. Client reports right upper quadrant pain upon palpation. Urine specimen obtained for urinalysis, dark yellow in color. Vital Signs 0900: Temperature 36.9° C (98.5° F) Heart rate 84/min Respiratory rate 18/min