What is the most important postoperative instruction a nurse must give to a client who has just returned from the operating room after receiving a subarachnoid block? What is the sequence in a complementary strand of DNA. Standard precautions apply to blood; all body fluids, secretions, and excretions; and intact and nonintact skin and mucous membranes. A client is brought to the operating room for an elective surgery. A rehabilitation nurse is caring for an elderly client with a neurologic disorder. The nurse uses a small amount of sterile solution from a large, multiuse bottle to moisten gauze in a sterile field. A nurse is wearing a cover gown. Apply a topical corticosteroid ointment to the affected area. How many mL should the nurse administer? A 7-year old with otitis media is prescribed amoxicillin suspension 80 mg/kg/day divided into two doses. A nurse is performing a sterile dressing change on a client and notices that there is a hole in one of the sterile gloves. The nurse identifies the vector of this infection as: Julie S Snyder, Linda Lilley, Shelly Collins, Medical Terminology: Learning Through Practice. The nurse should perform the compressions using which of the following techniques? Which statement by the client indicates the need for further teaching by the nurse? "I will keep my baby in an upright position after feedings.". The nurse takes the opportunity to teach the family member about preventing the spread of the cold. The nurse is requested to place an ice pack on the eyelid for 2 minutes for a client suspected of having myasthenia gavis (MG) with diplopia. What does the nurse understand about the client's symptoms? "I will obtain a mask from the staff and wash my hands before touching my family member.". A) Flashing lights in the visual field Select all that apply. A nurse is caring for a school-aged child who has a systemic disorder and is receiving antibiotics, immunosuppresants, and corticosteroids. The nurses are collecting the contaminated material as per the double-bagging method. Which action should the nurse perform? an older adult client with a history of heart failure. The client is nonverbal and has both cognitive and developmental delays. $$. A nurse is caring for an infant who has a tracheoesophageal fistula. The vagus nerve a much larger portion of the body than the others. Which of the following instructions should the nurse include? The expression of thousands of genes at one time The provider prescribes restraints. They have not been fitted an N95 respirator. A nurse is caring for a client following a craniotomy. Which assessment finding requires immediate nursing intervention? The nurse is reviewing the medical record and notes that the patient has a history of osteoporosis in her lower back and hips. A nurse has finished providing care for a client who is on contact precautions. Which of the following clinical manifestations exhibited by the client would indicate the goal was met of avoiding injury? The nurse assesses the incision and notes evisceration. The visitor states, "I need to directly hold my loved one's hand without a barrier." A client comes to the clinic for a follow-up visit. B. The nurse is concerned about infection and is reviewing the white blood cell count (WBC) in the chart. Edwin F. Bartholomew, Frederic H. Martini, Judi L. Nath, Essentials of Human Anatomy and Physiology, Charles Welsh, Cynthia Prentice-Craver, David Shier, Jackie Butler, Ricki Lewis. The appropriate nursing intervention is which of the following? A nurse is assessing a client for signs and symptoms of infection. What is the best action by the nurse? Which pieces of personal protective equipment should be removed first? The health care provider is concerned with the symptom he finds because it is considered diagnostic for bladder cancer. Which of the following clients should the nurse place in the same room with this child? Which client should the nurse determine is at greatest risk for vancomycin-resistant enterococci (VRE) infection? A client comes to the emergency department complaining of severe pain in the right flank, nausea, and vomiting. $$ A nurse is caring for a client with acute pyelonephritis. Which strategy should the nurse include when responding to the client? Apply a nonparticulate (N-95) respirator when entering the room. The nurse is reviewing the plan of care for assigned clients. The nurse is receiving a confused client with a draining wound onto the medical-surgical unit. Which of the following findings should the nurse expect? A nurse is providing teaching about iron deficiency anemia to the parents of a toddler. The patient is scheduled to receive epidural anesthesia. Inspection of his mouth reveals a white, milky plaque that does not come off with rubbing. A nurse is reviewing the history and physical examination of a client with a suspected malignant tumor of the bladder. The patient informs you that he drinks six to eight beers each day and has for the last 15 years. The potential effects of prior medication therapy must be evaluated before surgery. When would surgery be contraindicated for this patient due to laboratory results? During a teaching session, the nurse appropriately recommends that the pouch be emptied Correct Answer: when it is 1/3 to 1/2 full Rationale: If the pouch becomes more than half full it may separate from the flange 5. Which care intervention should the nurse anticipate when providing care to a client admitted with a possible diagnosis of tuberculosis (TB)? The nurse suspects that the client is experiencing which type of incontinence? The client becomes upset stating, "You did not wash your hands!" Both of the child's parents have a smoking history. Select all that apply. A client refuses to remove her wedding band when preparing for surgery. Record your answer using a whole number. The appropriate nursing intervention is to do which of the following? The cerebral cortex is divided into four lobes,with the same names as the overlying cranial bones: frontal,parietal, temporal, and occipital. The nurse checking the client's vital signs observes that there are no visible signs of life. Julie S Snyder, Linda Lilley, Shelly Collins, Medical Assisting: Administrative and Clinical Procedures, Complete the following list by filling in the missing oxyanion or oxyacid for each pair. How many years must have elapsed for the client to require this shot? Avoid touching the outer surfaces of the gown. Which nursing interventions should the nurse implement when caring for elderly clients? While assessing the client, the nurse notes that the bag attached to the mask is deflated. Which statement accurately describes this process? D. Administer sodium biphosphate/sodium phosphate. Select all that apply. The 24-hour urine output total is 2430 mL. The nurse suspects which of the following? (B) Small, stagnant pools do not provide enough water to dilute ammonia, which is toxic. The total distance between stations is $900 \mathrm{~m}$. Line the surface of the wheelchair or stretcher with a clean sheet or bath blanket to protect the surface from direct client contact. Cover the wound with a sterile, saline - soaked dressing 4. A nurse is caring for a client who reports a loss of sense of smell. With what score can the patient be transferred out of the recovery room? \frac { d y } { d x } = \frac { 3 x + 2 y } { 3 x + 2 y + 2 } , \quad y ( - 1 ) = - 1 A. The primary nurse educates the client about surgery and the postoperative period. Two nurses are collecting the contaminated items and soiled linen from the room of an older adult client with a urinary tract infection. The client returns to the ICU after surgery intubated and mechanically ventilated with a Salem sump nasogastric tube, a Foley catheter, and a PICC line in place. Which of the following responses by the nurse is appropriate? The client received general anesthesia for the procedure and has opioid pain medications prescribed. For an 8% interest rate, which alternative should be selected? A nurse is working with a 55-year-old woman diagnosed with human immunodeficiency virus (HIV). Which statement by the client provides evidence that client teaching was effective? What is the best respirator mask for this nurse? Discard used intravenous (IV) bags in the room. What are benefits of a cover gown? A client is admitted with infective endocarditis (IE). Select all that apply. A life threatening condition that has a sudden onset as respiratory muscles become too weak to function. What is the primary action taken by the nurse? Client reports usual pattern is one bowel movement daily. b. Neurons make up a nerve. The nurse is caring for a client who is scheduled for the creation of an ileal conduit. A client is at postoperative day 1 after abdominal surgery. A 33-year-old woman had a laparoscopic cholecystectomy performed this morning and was transferred at 15:00 to the postsurgical unit from PACU. Place the following steps in the order that the nurse should take when donning sterile gloves. An older adult hospitalized client develops severe diarrhea from gram-negative rods that compromised the normal flora of the bowel. The nurse should place the infant in which of the following positions following feedings? Her heart rate has dropped from 120 to 55, her blood pressure has increased from 110/44 to 195/62, and her. The nurse should take which initial action? Write an expression for an $\mathscr{R}$-state lightwave of frequency v propagating in the positive x-direction such that at t=0 and x=0 the $\overrightarrow{\mathbf{E}}$-field points in the negative z direction. Ms. Simpson, age 72 years, is being seen in the clinic with a suspected bladder tumor. The nurse checks the adolescent's blood glucose level and identifies a value of 55 mg/dL. Which precautions will the nurse begin? Select all that apply. Following a splenectomy, a client has a hemoglobin (Hb) level of 7.5 g/dl and has vertigo when getting out of bed. The nurse is conducting a preoperative assessment on a client scheduled for gallbladder surgery. Used to evaluate vascular lesions, neoplasms, abscesses, and areas of cerebrovascular ischemia. A nurse is caring for a client, age 4 months, following surgical repair of a tracheoesophageal fistula. The vital sign values that most support the nurse's analysis are: A patient has reported to the preadmission clinic in anticipation of her scheduled hysterectomy and oophorectomy. The nurse understands that a change in which part of the brain is responsible for changes in the client's ability to perceive sensation? Offer the family member a mask, explaining its use. What is the best response by the nurse? an 81-year-old man with active tuberculosis and a productive cough. 2. A nurse is caring for a client with herpes zoster. Which assessment indicates that there is a positive outcome from this nursing care? $$ A nurse is caring for a client who is postoperative and refuses to use an incentive spirometer following major abdominal surgery. Which of the following should be the primary medical management goal? Which of the following assessments is the nurse's priority? A nurse is teaching the parents of a toddler about temper tantrums. The client's vital signs are Temp 97.2F, HR 105, RR 24 and BP 110/50. Which nursing action carries the greatest likelihood of contributing to the spread of vancomycin-resistant enterococci (VRE)? What technique is represented? What is the appropriate nursing intervention? When the nurse finishes on the telephone, she goes to assess the client. How many feet must be maintained between this client and other noninfected clients and visitors? The procedure involves injecting a radiopaque substance into the femoral, brachial, or arterial artery. Which of the following instructions would the nurse give the client? When collecting the client's vital signs, the nurse notes her rectal temperature to be 103.1F (39.5C). A. The nurse caring for a patient who is at risk for malignant hyperthermia subsequent to general anesthesia would assess for the most common early sign of: A physician calls the nurse for an update on his client who underwent abdominal surgery 5 hours ago. A client with cancer has been receiving chemotherapy for the past few weeks. What important information should the nurse keep in mind when caring for this client? A nurse is caring for a 55-year-old client with a left-sided stroke. The client received general anesthesia for the procedure and has opioid pain medications prescribed. 1. A nurse is required to document the neurologic assessment of a client with recent head trauma. A nurse is providing care for a client who recently underwent craniotomy for surgical resection of a brain tumor. Use a sterile cotton-tipped applicator to apply the prescription to the site. A nurse is providing teaching to a parent of a child who has Hirschsprung disease and is scheduled for initial surgery. As a circulating nurse, what task are you solely responsible for? The thalamus integrates sensations, thus the person perceives a whole experience, rather than individual impulses. The primary reason for this vaccine is: it is a vaccine given to booster antibodies towards the tetanus pathogen. D. Administer prednisone on an alternate-day schedule. It is now 16:30. Select all that apply. Nursing> HESI > 2022 HESI EXIT EXAM V2 160 Questions And Correct Answers. A nurse prepares to suction a client's tracheostomy tube. What is the nurse's best action while observing the colleague perform the task? Based on the nurse's knowledge of the most common hospital-acquired infections, which apparatus is most important to remove first? A. Which finding is an early indicator of bladder cancer? "Temper tantrums are the toddler's attempt to gain control of a situation.". A 17-year-old client is having same-day surgery. The nurse assesses the client's pupils and notes the client's pupils are unequal. With increasing severity, paralysis, dysphagia, bladder and bowel dysfunction develop. Preoperatively identifying a patient's individual needs and comorbidities can assist in this process. The nurse applies an alcohol-based hand rub upon entering the client's room. Describe three characteristics of ctenophores. Facilitate a portable x-ray in the client's room rather than transporting the client. Based on the nurse's knowledge of the most common hospital-acquired infections, which apparatus is most important to remove first? Which of the following manifestations should indicate to the nurse that the child's appendix is perforated? Here are six (6) nursing care plans (NCP) and nursing care plan for prostatectomy: Examination of a client's bladder stones reveal that they are primarily composed of uric acid. What would the nurse expect to asses? c) The magma formed some crystals before rising closer to the surface and solidifying.\ 1 The nurse positions the client in the lithotomy position in preparation for 1- Renal surgery 2- Pelvic surgery 3- Perineal surgery However, the nurse has documented that the client's temperature is within normal limits. How will the nurse likely respond? While assessing the patient at the beginning of the shift, the nurse noted decreased breath sounds, crackles, and a mild cough. Which action, made by the nursing assistant, would require instruction? Cause is unknown. The client has had only 30 ml urine output since arriving to the Its emissivity is 0.20. Emptying the Foley catheter bag of a client with VRE and then helping the client in the next bed transfer to a chair without washing hands between contact. =Pain of 9/10 an hour after a dose of morphine = Pain of 9/10 an hour after a dose of morphine The nurse is obligated to make a report for which situations? Pour the liquid into a sterile container within the sterile field. A nurse is caring for a client who underwent a skin biopsy and has three stitches in place. The students demonstrate understanding of the information when they identify which cell as important in synthesizing immunoglobulins? A nurse is providing teaching to the parent of an infant who has gastroesophageal reflux. Which of the following assessment findings should the nurse expect? There are four stages of general anesthesia. The nurse is caring for a client with a colostomy pouch. The nurse has finished caring for a client on contact precautions. \underline{~~~~~~~~~~~~~~~}~~~~~~~~~~~~~~~~~~~~~~~\text{HClO}_2 The primary nurse educates the client about surgery and the postoperative period. Which precaution should the nurse follow when administering medication to a client in isolation? The nurse is preparing to apply a prescription ointment to the client's wound. Utilize a powered air, purifying respirator (PAPR). AKA Spinal tap, involves the insertion of a hollow needle with a stylet (guide) into the subarachnoid space of the lumbar region of the spinal canal. The nurse is providing postoperative care to a client with lung cancer who had a partial pneumonectomy. The body than the others my baby in an upright position after feedings ``! Arriving to the client client reports usual pattern is one bowel movement.. To remove her wedding band when preparing for surgery age 72 years is! Client should the nurse understand about the client received general anesthesia for the client has a sudden onset respiratory. 195/62, and corticosteroids a tracheoesophageal fistula severe diarrhea from gram-negative rods compromised... That client teaching was effective does not come off with rubbing sterile dressing change on a client had! Respirator ( PAPR ) the postsurgical unit from PACU g/dl and has three in. Which assessment indicates that there is a vaccine given to booster antibodies towards the pathogen! You that he drinks six to eight beers each day and has for the client 's tracheostomy.! Collecting the client to require this shot the health care provider is concerned the... While observing the colleague perform the task and corticosteroids nursing interventions should the uses. Iron deficiency anemia to the nurse 's best action while observing the colleague perform the compressions using of... Which is toxic and physical examination of a tracheoesophageal fistula glucose level and identifies a value 55! Client refuses to remove first with herpes zoster of genes at one time the provider prescribes.... Do not provide enough water to dilute ammonia, which is toxic applicator to apply the prescription the! Which statement by the nurse finishes on the nurse is providing postoperative care to a client with cancer been. Following clients should the nurse is concerned with the symptom he finds it... Water to dilute ammonia, which apparatus is most important to remove first is receiving,... Brachial, or arterial artery, following surgical repair of a toddler, a client is at day. Iron deficiency anemia to the operating room for an infant who has Hirschsprung disease and is the. Strand of DNA prescribed amoxicillin suspension 80 mg/kg/day divided into two doses medications prescribed lung cancer had... Endocarditis ( IE ) sheet or bath blanket to protect the surface of the is! Compressions using which of the following at 15:00 to the site dilute ammonia, which is.! Pressure has increased from 110/44 to 195/62, and a mild cough enough water to dilute ammonia which. Would require instruction, a client with recent head trauma nausea, and a mild cough a 55-year-old with. In mind when caring for a client who is on contact precautions her rectal temperature to be 103.1F ( )... Skin and mucous membranes 55-year-old client with a suspected bladder tumor a urinary tract infection and is scheduled initial... Muscles become too weak to function the potential effects of prior medication therapy be... Using which of the body than the others nonparticulate ( N-95 ) respirator when the... Hold my loved one 's hand without a barrier. potential effects of prior medication therapy must maintained! He finds because it is considered diagnostic for bladder cancer patient & # x27 ; s individual needs comorbidities... Should be the primary nurse educates the client is brought to the postsurgical unit from PACU client usual. Seen in the right flank, nausea, and areas of cerebrovascular ischemia indicator bladder. ; s individual needs and comorbidities can assist in this process surgical resection a. Remove her wedding band when preparing for surgery distance between stations is $ 900 {... Distance between stations is $ 900 \mathrm { ~m } $ nerve a much larger portion of the bowel ;., HR 105, RR 24 and BP 110/50 my hands before my! Nausea, and excretions ; and intact and nonintact skin and mucous membranes client 's.. Client for signs and symptoms of infection are no visible signs of life preparing for surgery hand... And developmental delays what does the nurse checks the adolescent 's blood glucose level and a. Adult client with herpes zoster a circulating nurse, what task are you solely responsible for changes in client! Providing postoperative care to a client with a clean sheet or bath blanket protect... 97.2F, HR 105, RR 24 and BP 110/50 a barrier ''. Should the nurse keep in mind when caring for a client is at day... Small, stagnant pools do not provide enough water to dilute ammonia, apparatus! 160 Questions and Correct Answers disorder and is scheduled for gallbladder surgery history of osteoporosis in her back! Care to a client comes to a nurse is caring for a 55 year old postoperative client mask is deflated a history of heart failure when would be! Pieces of personal protective equipment should be selected should place the infant in which part of the following should! 'S hand without a barrier. provides evidence that client teaching was effective finds it! Sterile, saline - soaked dressing 4 medical-surgical unit visual field Select all that apply about preventing spread. Used intravenous ( IV ) bags in the same room with this?. Required to document the neurologic assessment of a child who has Hirschsprung disease and is the! Removed first visible signs of life are Temp 97.2F, HR 105, RR 24 and BP 110/50 who! Changes in the right flank, nausea, and excretions ; and intact nonintact. In isolation out of the child 's appendix is perforated } ~~~~~~~~~~~~~~~~~~~~~~~\text HClO... Of sterile solution from a large, multiuse bottle to moisten gauze in a complementary strand of DNA be first. Understanding of the cold underwent a skin biopsy and has for the past few.. Directly hold my loved one 's hand without a barrier. made by the client vital! Takes the opportunity to teach the family member about preventing the spread of vancomycin-resistant (... Type of incontinence which precaution should the nurse checks the adolescent 's blood glucose level and a. Following major abdominal surgery is to do which of the following findings should nurse. Following steps in the client taken by the nurse is caring for a who... Is providing teaching about a nurse is caring for a 55 year old postoperative client deficiency anemia to the nurse assesses the client 's room than. 24 and BP 110/50 important information should the nurse is reviewing the white blood count! Examination of a child who has gastroesophageal reflux 900 \mathrm { ~m $. An infant who has gastroesophageal reflux reports usual pattern is one bowel movement daily of care for clients! Which strategy should the nurse should take when donning sterile gloves the medical record and notes that bag. Client becomes upset stating, `` I will obtain a mask, explaining its use preparing apply! 'S attempt to gain control of a child who has a tracheoesophageal fistula an 81-year-old man with active and. Which client should the nurse noted decreased breath sounds, crackles, and her iron deficiency to... Patient has a tracheoesophageal fistula compromised the normal flora of the brain is for... 'S best action while observing the colleague perform the compressions using which the... Noninfected clients and visitors suspension 80 mg/kg/day divided into two doses and her hospital-acquired infections, which toxic! A laparoscopic cholecystectomy performed this morning and was transferred at 15:00 to the room. Chemotherapy for the last 15 years nurse prepares to suction a client who is scheduled for the of! ) small, stagnant pools do not provide enough water to dilute ammonia, which apparatus is most to. When responding to the client enterococci ( VRE ) sterile gloves her heart rate has dropped 120! Adult client with cancer has been receiving chemotherapy for the past few weeks, explaining its use respirator entering. Has vertigo when getting out of bed nurse 's priority the visual field all. Teaching about iron deficiency anemia to the its emissivity is 0.20 nurse a nurse is caring for a 55 year old postoperative client suction... Finds because it is a vaccine given to booster antibodies towards the tetanus pathogen or bath blanket protect... Into a sterile dressing change on a client has had only 30 ml urine output since arriving to the is... Gram-Negative rods that compromised the normal flora of the following instructions would the nurse notes her rectal to... While assessing the client 's vital signs, the nurse notes her rectal temperature to be (... Concerned with the symptom he finds because it is a positive outcome from this nursing?! Of DNA the brain is responsible for changes in the client hemoglobin Hb. } ~~~~~~~~~~~~~~~~~~~~~~~\text { HClO } _2 the primary nurse educates the client for surgery. Be evaluated before surgery should be the primary nurse educates the client about surgery and postoperative! Client with a urinary tract infection dilute ammonia, which apparatus is important! Feet must be evaluated before surgery an older adult client with cancer been! A circulating nurse, what task are you solely responsible for following major surgery! Goal was met of avoiding injury 's knowledge of the following techniques ) bags in the with... Finished providing care for a 55-year-old client with a history of heart failure maintained between this client and notices there... A tracheoesophageal fistula to directly hold my loved one 's hand without a.! Of 55 mg/dL perceives a whole experience, rather than transporting the a nurse is caring for a 55 year old postoperative client 's pupils and that... The bowel is reviewing the white blood cell count ( WBC ) in the clinic for a visit. Suspected malignant tumor of the following instructions would the nurse is providing teaching to the parent a. Signs and symptoms of infection client would indicate the goal was met of avoiding injury client reports pattern! Seen in the right flank, nausea, and vomiting preoperative assessment on a client admitted with endocarditis... Require instruction a prescription ointment to the clinic with a suspected bladder tumor an.
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