Nokea
The nurse is caring for a client following a large volume paracentesis. To prevent hypovolemic shock, the nurse anticipates the primary healthcare provider (PHCP) to prescribe an infusion of
- A. 0.9% saline
- B. Albumin
- C. Mannitol
- D. 0.45% saline
Correct Answer: B
Rationale: Albumin is used post-paracentesis to restore intravascular volume and prevent hypovolemic shock by maintaining oncotic pressure. Saline solutions and mannitol do not effectively replace lost protein or maintain volume in this context.
You may also like to solve these questions
You are caring for a client who is in the burn unit with severe burns. Since this is your first client contact with this person, you introduce yourself and tell the client that they will be taken care of by you for this shift. The client greets you and states, 'Why am I getting this stuff that is hanging up here?' as they are pointing to the ordered total parenteral infusion. You should:
- A. Respond to the client stating, 'I don't think you should be getting this. I am going to call your doctor.'
- B. Respond to the client stating, 'This is total parenteral nutrition and you are getting it because your nutritional status is impaired as the result of your burns'.
- C. Respond to the client stating, 'This is total parenteral nutrition and you are getting it because your nutritional status is impaired because you aren't eating enough.'
- D. Respond to the client stating, 'I don't think you should be getting this. I am going to turn it off now.'
Correct Answer: B
Rationale: TPN (B) is used in burn patients to meet high nutritional demands when oral intake is insufficient due to metabolic stress from burns, not just lack of eating (C). Options A and D are inappropriate as they suggest stopping or questioning a valid treatment.
The nurse is caring for a client with diverticulosis who reports difficulty getting enough dietary fiber. The nurse should anticipate the primary healthcare provider (PHCP) will prescribe
- A. Psyllium
- B. Oil-retention enema
- C. Codeine
- D. Bisacodyl
Correct Answer: A
Rationale: Psyllium, a bulk-forming laxative, increases fiber intake, promoting regular bowel movements in diverticulosis. Enemas, codeine (which slows motility), and bisacodyl (a stimulant laxative) are not appropriate for increasing dietary fiber.
The following scenario applies to the next 6 items
The emergency department (ED) nurse is caring for a 45-year-old male client.
Item 1 of 6
Nurses’ Notes
0600: The client reports sudden, severe epigastric pain. He has a history of chronic alcohol use disorder (30+ years), GERD, and hypertension. His home medications include pantoprazole and lisinopril. Upon assessment, the client is noted to be alert and oriented x4. He is mildly diaphoretic, with pulses 2+ and regular. Abdomen is distended, guarding on palpation, diminished bowel sounds, and no stool in the last 24 hours. He reports nausea and vomiting, and his pain is worse after eating fatty foods, rated 7/10 and radiating to his back. Breath sounds slightly diminished bilaterally, no adventitious sounds, denies cough or dyspnea. He reports heavy alcohol intake two days ago. Fingerstick glucose is 145 mg/dL (8.06 mmol/L) [70-110 mg/dL; 4-6 mmol/L]. Temperature is 101.3°F (38.5°C), heart rate of 112 bpm, respiratory rate of 24 breaths/min, blood pressure of 98/64 mmHg, and oxygen saturation of 95% on room air.
Orders
0600
• Cardiac monitoring
• NPO
• CBC
• CMP
• LFTs
• Amylase
• Lipase
• CT abdomen with contrast
The nurse is reviewing the client's admission information. Select the findings that require immediate follow-up.
- A. The client reports sudden severe epigastric pain radiating to the back.
- B. He has a history of chronic alcohol use disorder (30+ years), GERD, and hypertension.
- C. His home medications include pantoprazole and lisinopril.
- D. Upon assessment, the client is noted to be alert and oriented x 4.
- E. He reports nausea and vomiting, and his pain is worse after eating fatty foods, rated 7/10.
- F. Breath sounds slightly diminished bilaterally, no adventitious sounds, denies cough or dyspnea.
- G. Temperature is $101.3°F (38.5°C), heart rate of 112 bpm, respiratory rate of 24 breaths/min, blood pressure of 98/64 mmHg, and oxygen saturation of 95% on room air.
Correct Answer: A,E,G
Rationale: Severe epigastric pain radiating to the back (A), nausea and vomiting worsened by fatty foods (E), and vital sign abnormalities (G) such as fever, tachycardia, and hypotension suggest acute pancreatitis, requiring urgent follow-up.
The nurse prepares a client for a computed tomography (CT) scan of their abdomen and pelvis with intravenous (IV) contrast. The nurse should take which action before the client's exam?
- A. Remove any medicated patches before the exam
- B. Instruct the client to empty their bladder right before the test
- C. Educate the client that they may experience a flushing sensation during the exam
- D. Assess the client for an implantable pacemaker
Correct Answer: C
Rationale: Educating about the flushing sensation (C) prepares the client for the common effect of IV contrast. Patches (A) are not routinely removed, emptying the bladder (B) is not critical, and pacemakers (D) are relevant for MRI, not CT.
The nurse is developing a teaching plan for a client with post-gastrectomy dumping syndrome. Which of the following statements should the nurse make to the client?
- A. Take small sips of water during meals to soften the food for easier digestion.
- B. Symptoms will resolve in about 4-6 weeks as the stomach adjusts post-surgery.
- C. Plan rest periods of 10 minutes after every meal.
- D. Meals should consist of dry foods with low carbohydrates, moderate fat, and high protein content.
Correct Answer: D
Rationale: Dry, low-carbohydrate, moderate-fat, high-protein meals (D) slow gastric emptying, reducing dumping syndrome symptoms. Sips during meals (A), expecting resolution in 4-6 weeks (B), or short rest periods (C) are incorrect.