Tüm alıştırma soruları

In an inpatient clinical setting, effective interpersonal interactions require the application of specific communication techniques. Match each statement made by a client with the most appropriate therapeutic nursing response.

A nurse is preparing to perform an abdominal assessment on an older adult client who reports new-onset abdominal cramping and altered bowel habits. Which of the following actions should the nurse include in the plan of care? (Select all that apply.)

A nurse is preparing to administer a prescribed intravenous (IV) push medication through a client's peripheral IV line. The client currently has a continuous primary IV infusion of a solution that is physically incompatible with the ordered IV push medication. In what order should the nurse perform the following actions to safely administer the medication? Arrange the steps from first to last.

A nurse is reviewing the arterial blood gas (ABG) results for a client who is experiencing acute respiratory distress. The results show a pH of $7.25$, $\text{PaCO}_2$ of $60\text{ mm Hg}$, and $\text{HCO}_3^-$ of $24\text{ mEq/L}$. Based on these values, which acid-base imbalance is the client experiencing?

A nurse is caring for a client who is four hours post-operative following a total thyroidectomy. The client suddenly becomes highly agitated and reports a sensation of intense pressure and fullness in the neck. Upon inspection, the surgical dressing is dry and intact, but the nurse auscultates high-pitched, harsh respiratory sounds during inspiration. The client's voice has become noticeably muffled. Which action should the nurse take immediately?

A nurse is assessing a client who has a suspected proximal small bowel obstruction and has experienced severe, persistent vomiting for the past 24 hours. Which of the following clinical findings should the nurse identify as physiological complications associated with this condition? Select all that apply.

A nurse is assessing a client who is 4 hours post-admission for a severe pelvic fracture following a motor vehicle crash. The client's baseline vital signs upon admission were: blood pressure 130/76 mm Hg, heart rate 82/min, and respiratory rate 16/min. Which of the following current assessment findings indicate the client is entering the early (compensatory) stage of hypovolemic shock? Select all that apply.

A client is receiving intravenous morphine via a patient-controlled analgesia (PCA) pump following a bowel resection. During hourly rounds, the nurse notes the client has a respiratory rate of $8 \text{ breaths/minute}$, pinpoint pupils, and is unresponsive to physical stimulation. The nurse immediately stops the PCA pump, calls for assistance, and receives a verbal prescription for naloxone $0.4 \text{ mg}$ IV stat. Which action by the nurse demonstrates the safest administration technique for this medication?

A triage nurse evaluates a client presenting with a 4-day history of frequent, watery diarrhea and an inability to drink fluids. The client is lethargic and exhibits delayed capillary refill. Assessment reveals a heart rate of 124 beats/minute, a respiratory rate of 30 breaths/minute with deep chest excursions, and a blood pressure of 94/76 mm Hg. Arterial blood gas (ABG) testing indicates a pH of 7.25, PaCO2 of 27 mm Hg, HCO3 of 12 mEq/L, and PaO2 of 96 mm Hg on room air. Which of the following actions should the nurse perform FIRST?

A nurse is developing a plan of care for a client who will be returning to the medical-surgical unit following a percutaneous liver biopsy. Which of the following nursing actions should be included to reduce the risk of post-procedure complications? Select all that apply.

While assessing a client receiving intravenous fluids via a central venous catheter (CVC), the nurse notes that the intravenous tubing has completely disconnected from the catheter hub. The client suddenly gasps, becomes severely dyspneic, and exhibits circumoral cyanosis. Arrange the following nursing actions in the correct order of prioritization.

A nurse is providing care for a confused client who repeatedly attempts to dislodge their peripheral intravenous (IV) catheter. Which of the following actions should the nurse implement first as a less restrictive alternative to physical restraints?

A registered nurse enters a client's room and discovers the client lying supine on the floor next to the bed. Arrange the following nursing actions in the correct priority sequence from first to last.

While documenting at the central station of a high-risk perinatal unit, the registered nurse receives status updates from the care team regarding four clients. Which client presentation mandates the most urgent assessment by the nurse?

A registered nurse (RN) is caring for a critically ill client diagnosed with sepsis. The client's current vital signs include a blood pressure of $88/54\text{ mmHg}$, heart rate of $112\text{ beats/min}$, and a temperature of $38.9^\circ\text{C}$ ($102^\circ\text{F}$). The client is receiving a continuous intravenous (IV) infusion of dopamine through a single-lumen peripheral IV catheter to maintain hemodynamic stability. The healthcare provider prescribes a new intermittent IV piggyback of piperacillin-tazobactam. Which of the following actions by the nurse demonstrate safe pharmacological and parenteral practices? (Select all that apply.)

A pediatric nurse is assessing the developmental milestones of various clients. Arrange the following play behaviors in the chronological order in which they typically emerge, from the earliest stage of childhood to the latest.

A home health registered nurse is developing a care plan for a 78-year-old client who recently transitioned to living with their adult children. Which of the following actions should the nurse include in the client's comprehensive health screening plan? Select all that apply.

A client with alcohol-induced major neurocognitive disorder is receiving intravenous antibiotics for healthcare-associated pneumonia on a medical-surgical unit. The client is profoundly disoriented and has successfully disconnected their intravenous infusion line twice during the current shift. After multiple less restrictive measures have failed to maintain line security, the healthcare provider prescribes physical limb restraints. Which comprehensive approach must the registered nurse implement to ensure compliance with legal mandates and client safety protocols?

While delivering a meal tray, a staff nurse observes that a privacy curtain has caught fire from a malfunctioning electrical outlet in a semi-private room. Both clients are currently in their beds. Which action must the nurse take first?

A nurse is preparing a client with severe, treatment-resistant major depressive disorder for electroconvulsive therapy (ECT). Arrange the following nursing actions in the chronological order they should be performed, from first to last.