PrepU Review : NU 325

A client is hospitalized for open reduction of a fractured femur. During the postoperative assessment, the nurse notes that the client is restless and observes petechiae on the client's chest. Which nursing action is indicated first?

-administer oxygen.

A client has been receiving chemotherapy. Upon assessing the client during morning rounds, the nurse notes the client is now bleeding from intravenous and venipuncture sites. Stool is positive for occult blood. The client is requesting to sit in a chair for a meal. The nurse implements the following interventions: (Select all that apply.)

-assess level of consciousness. -apply pressure to the bleeding sites. -check intake and output records.

The client is receiving a vesicant antineoplastic for treatment of cancer. Which assessment finding would require the nurse to take immediate action?

-extravasation

A nurse is planning the care of an older adult client who will soon be discharged home after treatment for a fractured hip. In an effort to prevent future fractures, the nurse should encourage what actions? Select all that apply.

-regular bone density testing -a high-calcium diet -use of falls prevention precautions -weight-bearing exercise

The client is diagnosed with a benign brain tumor. Which of the following features of a benign tumor is of most concern to the nurse?

-tumor pressure against normal tissues

A PACU nurse is caring for a postoperative client who received general anesthesia and has a hard, plastic oral airway in place. The patient has clear lung sounds, even and unlabored respirations of 16, and 98% oxygen saturation. The client is minimally responsive to painful stimuli. What action by the nurse is most appropriate?

-continue with frequent client assessments.

During the preoperative assessment, the client mentions allergies to avocados, bananas, and hydrocodone. What is the priority action by the nurse?

-notify the surgical team to remove all latex-based items.

What is the priority action when the circulating nurse is completing a second verification of the surgical procedure and surgical site?

-obtain the attention of all members of the surgical team.

Which actions by the nurse demonstrate an understanding of caring for a client in traction? Select all that apply.

-placing a trapeze on the bed -ensuring that the weights are hanging freely -assessing the client's alignment in the bed -frequently assessing pain level

A nurse is assessing the postoperative client on the second postoperative day. What assessment finding requires the nurse to immediately notify the health care provider?

-the client has an absence of bowel sounds.