QUESTIONS AND FULL ANSWER KEY
◉ Chapter 96
A nurse is reviewing the health records of several clients in the post
anesthesia care unit (PACU) to identify risk factors that can lead to
post op complications. Which of the following clients are at risk for
complications? select all that apply
A. a client who has a WBC of 22,500
B. A client who uses an insulin pump
C. A client who takes warfarin daily
D. A client who has heart failure
E. A client who has a BMI of 26. Answer: a, b, c and d
◉ Chapter 96
A nurse is caring for a female client who manifests indications of
hypovolemia while in the PACU. Which of the following findings
requires action by the nurse? select all that apply
A. Urine output less than 25 ml/hr
B. Hematocrit 48%
C. BUN 24
D. Tenting over skin of the sternum
, E. Apical pulse of 62/min. Answer: a, b, c and d
◉ Chapter 96
A nurse is caring for a client who arrive in the PACU following a total
hip arthroplasty. The client is not responding to verbal stimuli.
Which of the following actions should the nurse perform first?
A. Compare and contrast the peripheral pulses
B. Apply a warm blanket
C. Assess dressings
D. Place the client in a lateral position. Answer: d
◉ Chapter 96
A nurse is planning care for a client to prevent post op atelectasis.
Which of the following interventions should the nurse include in the
plan of care? select all that apply
A.Encourage use of incentive spirometer every 2 hours
B. Instruct the client to splint the incision when coughing and deep
breathing
C. Reposition the client every 2 hours
D. Administer antibiotic therapy
E. Assist with early ambulation. Answer: a, b, c and e
◉ Chapter 96