Study guides, Class notes & Summaries

Which assessment is most important for the nurse to perform on a client who is hospitalized for Guillain-Barre syndrome that is rapidly progressing? A: Respiratory effort. B: Unsteady gait. C: Intensity of pain. D: Ability to eat. correct answers A: Respiratory Effort (Guillain-Barre syndrome causes paralysis or weakness that typically starts at the feet and progresses upwards. As the condition progresses, the nurse must ensure that the client is able to breathe effectively.) A male cl...

The nurse assesses a patient with shortness of breath for evidence of long-standing hypoxemia by inspecting: A. Chest excursion B. Spinal curvatures C. The respiratory pattern D. The fingernail and its base correct answers D. The fingernail and its base Clubbing, a sign of long-standing hypoxemia, is evidenced by an increase in the angle between the base of the nail and the fingernail to 180 degrees or more, usually accompanied by an increase in the depth, bulk, and sponginess of the end o...

The nurse is evaluating the male clients understanding of diet teaching about DASH (Dietary Approach to Stop Hypertension) eating plan. Which behavior indicates that the client is adhering to the eating plan? correct answers Enjoys fat free yogurt as an occasional snack food. A client with carcinoma of the lung is complaining of weakness and has a serum sodium level of 117 mEq/L which nursing problem should the nurse include in this clients care plan? correct answers Fluid volume excess th...

A female client with a nasogastric tube attached to low suction states that she is nauseated. The nurse assesses that there has been no drainage through the nasogastric tube in the last 2 hours. Which action should the nurse take first? A. Irrigate the nasogastric tube with sterile normal saline. B. Reposition the client on her side. C. Advance the nasogastric tube 5 cm. D. Administer an intravenous antiemetic as prescribed. correct answers B. The priority is to determined if the tube is f...

The nurse is evaluating a male client's understanding of diet teaching about DASH (dietary approaches to stop hypertension) eating plan. Which behavior indicates that the client is adhering to the eating plan correct answers Enjoys fat free yogurt as an occasional snack food A client with carcinoma of the lung is complaining of weakness and has a serum sodium level of 117 mEq/L. Which nursing problem should the nurse include in this client's plan of care? A) Altered Urinary Elimination ...

The nurse is providing care to a client after a percutaneous transluminal coronary angioplasty (PTCA). What actions will the nurse include in the client's plan of care? (Select all that apply.) correct answers A.Frequent vital signs. B.Determine if the client is allergic to aspirin. D.Offer fluids of choice. F.Monitor infusion of IV nitroglycerine. In assessing a client diagnosed with primary aldosteronism, the nurse expects the laboratory test results to indicate a decreased serum level ...

The nurse is concerned about infection for a client after an esophagogastrostomy for esophageal cancer. Which actions should the nurse include in the client's plan of care? (Select all that apply.) A. Frequent oral care every 2 hours while awake. B. Use incentive spirometer every 2 hours. C. Empty contents from NG tube every 8 hours. D. Ambulate within 1 hour of return from the PACU. E. Limit visitors until postoperative day 2. correct answers Correct Answer: A,B,C Rationale:One hour ...

The nurse is conducting a session about the principles of first aid and is discussing the interventions for snakebite to an extremity. The nurse should inform those attending the session that the first priority intervention in the event of this occurrence is which action? 1. Immobilize the affected extremity. 2. Remove jewelry and constricting clothing from the victim. 3. Place the extremity in a position so that it is below the level of the heart. 4. Move the victim to a safe area away fr...

Med Surg Final HESI Complete Questions and Answers 100% Verified Latest 2024 A client with a productive cough has obtained a sputum specimen for culture as instructed. What is the best initial nursing action?