RN Adult Medical Surgical Online Practice
t t t t t t
2023 A NGN t t
NGN
1000:
Clienttistalerttandtorientedtandtreportstnottfeelingtwelltfortatfewtdays.tClienttistontcontinuousta
mbulatorytperitonealtdialysist(CAPD)tandtreportstdialysatetappearedtcloudytthistmorning.
Reportstabdominaltpaintast4tontatscaletoft0ttot10.
Boweltsoundstactivetintalltquadrants.
Peritonealtdialysistaccesstsitetred,twarmttottouch,twithtatsmalltamounttoftpurulenttdrainagetn
otedtontdressing.1300:
Clienttistlyingtintbedtwithtthetkneestflexed,tguardingtthetabdomen.tAbdomentistslightlytdisten
ded,thypoactivetboweltsounds.tClienttreportstnausea.tReportstpaintast6tontatscaletoft0ttot10.t
Providertnotifiedtandtupdatedtwithtclienttconditiontandtdiagnostictresults.t-
tThetclienttistexperiencingtmanifestationstoft
peritonitis
duettot
x-raytresults
.
NGN
Clienttadmittedttotmedical-
surgicaltunittfromtPACU.tClienttreportstincisionaltpaintast2tontatscaletoft0ttot10.tClienttappear
strestlesstandtfrequentlytaskstfortwater.tBilateraltlowertextremitiestcooltwitht+1tpedaltpulses.t
Urinetoutputtist40tmLtfortthetpastt2thr.tModeratetamounttoftbrighttredtdrainagetnotedtontsurgi
caltincisiontdressing.t-tInserttatlarge-gaugetIV.
Initiatetatfluidtchallenge.
Hypovolemia
Urinetoutput
Bloodtpressure
Atnursetistcaringtfortatclienttwhothastatpotassiumtleveltoft3tmEq/L.tWhichtoftthetfollowingtass
essmenttfindingstshouldtthetnursetexpect?t-tHypoactivetBoweltSounds
NGN
0900:
Clienttpresentstwithtabdominaltpaintintthetuppertlefttquadranttfortthetpastt2tdays.tStatestpaint
becametworsetthistmorningtandtistradiatingttotthetback.tRatestpaintast8tontatscaletoft0ttot10.
Hypoactivetboweltsounds;treportstnausea,tnotvomiting;tclienttistpassingtflatus.
Febrile,torientedttotperson,tplace,tandttime.
Tachypneatwithtdiminishedtbreathtsounds.
, Sinusttachycardia.
Clienttvoidst300tmLtoftclear,tamberturine.
0930:
Clienttvomitedt100tmLtbrowntliquid.t-tThetclienttistexperiencingtmanifestationstoft
pancreatitis
astevidencedtbytthet
amylasetandtlipase
.
0530:
Clienttistawaketandtalert.
Arteriovenoustfistulat(AVF)ttotrighttforearmtwithtthrilltpalpatedtandtauscultatedtfortbruit.tLung
tsoundstcleartupontauscultation; tclienttdeniestshortnesstof tbreath.tNotperipheraltedematnot
ed;tcapillarytrefilltistlesstthant3tseconds;t+2tbilateraltpedaltandtradialtpulses.
AVFtaccesstpreparedtandtcannulatedttwicetwithtnotdifficulty.tLinestarettapedtandtsecured;ttr
eatmenttistinitiated.0600:
Clienttistreadingtatbook.tAccesstistvisible,tandtlinestaretsecure.tClienttreportstnotdiscomfortto
rtpain.0630:
Clienttreportstfeelingtwarm,tnauseated,tandtlightheaded;tappearstrestlesstandtslightlytconfu
sed.t-tPerformtat12-leadtECGtistnottindicated.
PlacetthetclienttintTrendelenburgtpositiontistindicated.
Administertat0.9%tsodiumtchloridet200tmLtIVtbolustistindicated.t
Applytoxygentatt2tL/mintviatnasaltcannulatistindicated
Notifytthetprovidertimmediatelytistindicated
Obtaintthetclient'stbloodtglucosetleveltistnottindicated.
1800:
Emergencytmedicaltteamtremovedtclient'stshirttattthetscenetandtinitiatedt18-
gaugetIVttherapytintthetrighttantecubitaltspace.
Clientthastfull-thicknesstburnstovertthetupperthalftoftthetchesttandtbothtforearms;tpartial-
thicknesstburnstaretpresenttontthetclient'stfacetandtneck.
Sinusttachycardia,tpulsesttotbrachialtextremitiestpalpable.t1+tedemattotuppertextremities.
Respirationsteven,tlaboredtwithtscatteredtrhonchi.tSoottnotedttotthetclient'stmouthtandtnose.
tOxygent40%tviatfacettenttapplied.
Hypoactivetboweltsounds.
16tFrenchtindwellingturinarytcathetertinsertedtwithtreturntoft250tmLtoftyellowturine.
LactatedtRinger'stinfusingttotrighttantecubital.tProvidertpreparingttotinserttrighttfemoraltcentr
altlinetcatheter.
1830:
t t t t t t
2023 A NGN t t
NGN
1000:
Clienttistalerttandtorientedtandtreportstnottfeelingtwelltfortatfewtdays.tClienttistontcontinuousta
mbulatorytperitonealtdialysist(CAPD)tandtreportstdialysatetappearedtcloudytthistmorning.
Reportstabdominaltpaintast4tontatscaletoft0ttot10.
Boweltsoundstactivetintalltquadrants.
Peritonealtdialysistaccesstsitetred,twarmttottouch,twithtatsmalltamounttoftpurulenttdrainagetn
otedtontdressing.1300:
Clienttistlyingtintbedtwithtthetkneestflexed,tguardingtthetabdomen.tAbdomentistslightlytdisten
ded,thypoactivetboweltsounds.tClienttreportstnausea.tReportstpaintast6tontatscaletoft0ttot10.t
Providertnotifiedtandtupdatedtwithtclienttconditiontandtdiagnostictresults.t-
tThetclienttistexperiencingtmanifestationstoft
peritonitis
duettot
x-raytresults
.
NGN
Clienttadmittedttotmedical-
surgicaltunittfromtPACU.tClienttreportstincisionaltpaintast2tontatscaletoft0ttot10.tClienttappear
strestlesstandtfrequentlytaskstfortwater.tBilateraltlowertextremitiestcooltwitht+1tpedaltpulses.t
Urinetoutputtist40tmLtfortthetpastt2thr.tModeratetamounttoftbrighttredtdrainagetnotedtontsurgi
caltincisiontdressing.t-tInserttatlarge-gaugetIV.
Initiatetatfluidtchallenge.
Hypovolemia
Urinetoutput
Bloodtpressure
Atnursetistcaringtfortatclienttwhothastatpotassiumtleveltoft3tmEq/L.tWhichtoftthetfollowingtass
essmenttfindingstshouldtthetnursetexpect?t-tHypoactivetBoweltSounds
NGN
0900:
Clienttpresentstwithtabdominaltpaintintthetuppertlefttquadranttfortthetpastt2tdays.tStatestpaint
becametworsetthistmorningtandtistradiatingttotthetback.tRatestpaintast8tontatscaletoft0ttot10.
Hypoactivetboweltsounds;treportstnausea,tnotvomiting;tclienttistpassingtflatus.
Febrile,torientedttotperson,tplace,tandttime.
Tachypneatwithtdiminishedtbreathtsounds.
, Sinusttachycardia.
Clienttvoidst300tmLtoftclear,tamberturine.
0930:
Clienttvomitedt100tmLtbrowntliquid.t-tThetclienttistexperiencingtmanifestationstoft
pancreatitis
astevidencedtbytthet
amylasetandtlipase
.
0530:
Clienttistawaketandtalert.
Arteriovenoustfistulat(AVF)ttotrighttforearmtwithtthrilltpalpatedtandtauscultatedtfortbruit.tLung
tsoundstcleartupontauscultation; tclienttdeniestshortnesstof tbreath.tNotperipheraltedematnot
ed;tcapillarytrefilltistlesstthant3tseconds;t+2tbilateraltpedaltandtradialtpulses.
AVFtaccesstpreparedtandtcannulatedttwicetwithtnotdifficulty.tLinestarettapedtandtsecured;ttr
eatmenttistinitiated.0600:
Clienttistreadingtatbook.tAccesstistvisible,tandtlinestaretsecure.tClienttreportstnotdiscomfortto
rtpain.0630:
Clienttreportstfeelingtwarm,tnauseated,tandtlightheaded;tappearstrestlesstandtslightlytconfu
sed.t-tPerformtat12-leadtECGtistnottindicated.
PlacetthetclienttintTrendelenburgtpositiontistindicated.
Administertat0.9%tsodiumtchloridet200tmLtIVtbolustistindicated.t
Applytoxygentatt2tL/mintviatnasaltcannulatistindicated
Notifytthetprovidertimmediatelytistindicated
Obtaintthetclient'stbloodtglucosetleveltistnottindicated.
1800:
Emergencytmedicaltteamtremovedtclient'stshirttattthetscenetandtinitiatedt18-
gaugetIVttherapytintthetrighttantecubitaltspace.
Clientthastfull-thicknesstburnstovertthetupperthalftoftthetchesttandtbothtforearms;tpartial-
thicknesstburnstaretpresenttontthetclient'stfacetandtneck.
Sinusttachycardia,tpulsesttotbrachialtextremitiestpalpable.t1+tedemattotuppertextremities.
Respirationsteven,tlaboredtwithtscatteredtrhonchi.tSoottnotedttotthetclient'stmouthtandtnose.
tOxygent40%tviatfacettenttapplied.
Hypoactivetboweltsounds.
16tFrenchtindwellingturinarytcathetertinsertedtwithtreturntoft250tmLtoftyellowturine.
LactatedtRinger'stinfusingttotrighttantecubital.tProvidertpreparingttotinserttrighttfemoraltcentr
altlinetcatheter.
1830:
