Nokea
A male client who had colon surgery 3 days ago is anxious and requesting assistance to reposition. While the nurse is turning him, the wound dehiscences and eviscerates. The nurse moistens an available sterile dressing and places it over the wound. What intervention should the nurse implement next?
- A. Bring additional sterile dressing supplies to the room
- B. Prepare the client to return to the operating room
- C. Obtain a sample of the drainage to send to the lab
- D. Auscultate the abdomen for bowel sound activity
Correct Answer: B
Rationale: Evisceration is a surgical emergency and requires immediate return to the operating room for repair.
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A client with chronic kidney disease (CKD) arrives at the clinic reporting shortness of breath on exertion and extreme weakness. Vital signs are temperature 100.4°F (38°C), heart rate 110 beats/minute, respirations 28 breaths/minute, and blood pressure 175/98 mmHg. The client usually receives dialysis three times a week but missed the last treatment. STAT blood specimens are sent to the laboratory for analysis. Which laboratory results should the nurse report to the healthcare provider immediately?
- A. Potassium 6.5 mEq/L (mmol/L)
- B. Potassium 6 mEq/L (mmol/L)
- C. Potassium 0.5 mEq/L (mmol/L)
- D. Potassium 1.5 mEq/L (mmol/L)
Correct Answer: A
Rationale: Elevated potassium levels in CKD clients can lead to life-threatening arrhythmias, so this result needs immediate intervention.
Complications of long-term TPN administration are:
- A. Selenium deficiency
- B. Abnormal liver function tests
- C. Osteopaenia
- D. Renal failure
Correct Answer: A
Rationale: Selenium deficiency is a known complication of long-term total parenteral nutrition (TPN) due to inadequate trace element supplementation.
What is one reason why patients with CHD are more likely to have rejection post-transplant than those with cardiomyopathy?
- A. Sensitized recipients with panel reactive antibody (PRA)
- B. Absence of systemic disease
- C. History of good compliance
- D. None of the above
Correct Answer: A
Rationale: Patients with congenital heart disease (CHD) are often sensitized due to prior surgeries and blood transfusions, leading to a higher risk of rejection post-transplant.
Causes for hypertension in childhood
- A. PDA
- B. Hemolytic uremic syndrome
- C. Guillain-Barre syndrome
- D. Lead poisoning
Correct Answer: A
Rationale: Patent ductus arteriosus (PDA) is a common cause of hypertension in childhood.
Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood?
- A. The patent ductus arteriosus
- B. A ventricular septal defect
- C. The closure of the foramen ovale
- D. An atrial septal defect
Correct Answer: D
Rationale: Because the right side of the heart must take over pumping blood to both the lungs and systemic circulation, the ductus arteriosus must remain open to shunt the oxygenated blood from the lungs.