Physiological Integrity

A client with severe generalized weakness is confined to bed. To promote physical comfort and prevent complications related to immobility, which positioning techniques should the practical nurse implement? (Select all that apply.)

A practical nurse (PN) is collecting data on a client who is 6 hours postpartum following an uncomplicated vaginal delivery. Which finding is the priority to report to the registered nurse immediately?

Four hours following an uncomplicated vaginal delivery, a postpartum client reports feeling unusually tired. Upon evaluation, the nurse observes that the client has completely saturated a perineal pad with dark red blood within the last 45 minutes. The current assessment shows a heart rate of 106 beats/minute and a blood pressure of 104/68 mm Hg, a change from the baseline of 82 beats/minute and 126/78 mm Hg. Which action should the nurse take first?

A practical nurse is assigned to care for a client who returned to the surgical unit 2 hours ago following a subtotal thyroidectomy. The client reports mild incisional discomfort. Which positioning intervention should the nurse implement to promote comfort and minimize tension on the surgical site?

While reviewing the morning chart for a client treated for heart failure, a practical nurse notes a serum potassium result of $3.0$ mEq/L (reference range: $3.5$ to $5.0$ mEq/L). The medication record indicates upcoming scheduled doses of oral furosemide and oral potassium chloride. Which step is most appropriate for the nurse to take?

The practical nurse (PN) is providing care for a group of clients on a medical-surgical unit. Which of the following actions by the PN demonstrate appropriate risk reduction and safe clinical practice? Select all that apply.

A client with a spinal cord injury at the T4 level reports a sudden, severe pounding headache and blurred vision. The practical nurse (PN) notes the client is profusely sweating and has a flushed face. The client's blood pressure is 208/112 mm Hg. In what order should the PN perform the following actions? Arrange the actions from first to last.

The healthcare provider prescribes oral ibuprofen for a toddler who weighs $33$ pounds and has a temperature of $101.2^\circ\text{F}$ ($38.4^\circ\text{C}$). The prescribed dosage is $10\text{ mg/kg}$ per dose. The available medication is an oral suspension labeled $100\text{ mg}/5\text{ mL}$. How many milliliters should the nurse administer for a single dose?

Record your answer to the nearest tenth. Do not include units in the answer.

An older adult client is prescribed oral digoxin $0.125$ mg once daily. The unit's automated medication dispenser supplies digoxin in scored tablets of $0.25$ mg. Prior to administration, the practical nurse assesses the client's apical pulse and obtains a rate of $74$ beats per minute. Which action should the practical nurse take?

A practical nurse is providing care for a 75-year-old client who had a bowel resection two days ago. The client's morning vital signs were: blood pressure 104/68 mm Hg, heart rate 96 beats/min, respirations 20 breaths/min, and oxygen saturation 94% on room air. Two hours later, the client suddenly becomes highly restless, confused, and attempts to climb out of bed. Which action should the practical nurse take first?

A licensed practical nurse is caring for an adult client who underwent an open reduction and internal fixation of a right femur fracture 8 hours ago. During the current assessment, the nurse notes a heart rate of 118 beats/minute, a blood pressure of 96/62 mm Hg, and a respiratory rate of 22 breaths/minute. Additionally, the surgical dressing exhibits a newly formed, 4-cm diameter area of sanguineous drainage. What is the priority action for the nurse to take?

A practical nurse (PN) is caring for a client with osteoporosis who is scheduled to receive a weekly dose of oral risedronate. Which of the following actions must the PN take to safely administer this medication and reinforce client teaching? Select all that apply.

An individual is recovering in the surgical unit 48 hours after undergoing a right below-the-knee amputation. As part of basic care and comfort, which of the following interventions should be implemented? Select all that apply.

A practical nurse (PN) is assigned to a 78-year-old client who underwent an open reduction and internal fixation (ORIF) of a right femur fracture 24 hours ago. Which of the following actions by the PN demonstrate appropriate clinical judgment regarding the client's physiological adaptation? Select all that apply.

A practical nurse (PN) is assigned to collect a sterile urine specimen for culture and sensitivity from a client with a continuous indwelling urinary catheter. In what order should the PN perform the following actions to ensure specimen integrity and minimize the risk of infection? Arrange the steps in the correct chronological sequence.

A woman is resting in her hospital room a few hours after a right-sided modified radical mastectomy with axillary lymph node dissection. To promote optimal comfort and prevent complications, how should the practical nurse position the client's right arm?

A practical nurse (PN) is preparing to administer a scheduled dose of oral cephalexin to a client in an acute care facility. Upon entering the room, the PN observes that the client is not wearing an identification wristband. The client is alert, oriented, and states, 'I took the band off because it was scratching my arm.' Which action should the PN take?

A client with stable angina is prescribed a daily nitroglycerin transdermal patch. Place the following steps for applying the patch in the correct sequential order. (Move the steps into the correct order, starting with the first action.)

A practical nurse is preparing to transfer a client with right-sided weakness (hemiparesis) from the bed to a wheelchair. Arrange the following nursing actions in the correct sequence to ensure a safe transfer.

A client who is three days postoperative following an abdominal laparotomy suddenly reports a "popping" sensation after a forceful cough. The practical nurse examines the surgical site and observes that the incision has separated and a loop of bowel is protruding. In which order should the nurse perform the following actions? (Arrange from first action to last)