Midterm (emergency, msk, caridac)

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The nurse reviews the medical record of a patient with pneumonia and notes that the patient has hypotension, hypothermia, leukocytosis, and hypoxemia. What should the nurse infer from these findings? 1 The patient has septic shock. 2 The patient has neurogenic shock. 3 The patient has cardiogenic shock. 4 The patient has hypovolemic shock.

1 The patient has septic shock.

Colchicine is prescribed for a client with a diagnosis of gout. The nurse reviews the client's record, knowing that this medication would be used with caution in which disorder? 1. Myxedema 2. Kidney disease 3. Hypothyroidism 4. Diabetes mellitus

2. Kidney disease

A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus is scheduled for cardiac catheterization. Which medication would need to be withheld for 24 hours before the procedure and for 48 hours after the procedure? 1. Glipizide 2. Metformin 3. Repaglinide 4. Regular insulin

2. Metformin

The nurse has conducted teaching with a client in an arm cast about the signs and symptoms of compartment syndrome. The nurse determines that the client understands the information if the client states that he or she should report which early symptom of compartment syndrome? 1. Cold, bluish-colored fingers 2. Numbness and tingling in the fingers 3. Pain that increases when the arm is dependent 4. Pain that is out of proportion to the severity of the fracture

2. Numbness and tingling in the fingers

The nurse is evaluating a client's response to cardioversion. Which assessment would be the priority? 1. Blood pressure 2. Status of airway 3. Oxygen flow rate 4. Level of consciousness

2. Status of airway

The nurse is monitoring a client who is taking propranolol. Which assessment finding indicates a potential adverse complication associated with this medication? 1. The development of complaints of insomnia 2. The development of audible expiratory wheezes 3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after 2 doses of the medication 4. A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72 beats/minute after 2 doses of the medication

2. The development of audible expiratory wheezes

The nurse is caring for a client with a diagnosis of gout. Which laboratory value would the nurse expect to note in the client? 1. Calcium level of 9.0 mg/dL (2.25 mmol/L) 2. Uric acid level of 9.0 mg/dL (0.54 mmol/L) 3. Potassium level of 4.1 mEq/L (4.1 mmol/L) 4. Phosphorus level of 3.1 mg/dL (1.0 mmol/L)

2. Uric acid level of 9.0 mg/dL (0.54 mmol/L)

A client with myocardial infarction is developing cardiogenic shock. Because of the risk of myocardial ischemia, what condition should the nurse carefully assess the client for? 1. Bradycardia 2. Ventricular dysrhythmias 3. Rising diastolic blood pressure 4. Falling central venous pressure

2. Ventricular dysrhythmias

A patient experiences a myocardial infarction (MI). The nurse closely monitors the patient for complications and recognizes that hypotension is a warning sign of: 1 A secondary MI 2 Pulmonary edema 3 Cardiogenic shock 4 Fatal dysrhythmias

3 Cardiogenic shock

The nurse is administering an intravenous dose of methocarbamol to a client with multiple sclerosis. For which adverse effect should the nurse monitor? 1. Tachycardia 2. Rapid pulse 3. Bradycardia 4. Hypertension

3. Bradycardia

A client is wearing a continuous cardiac monitor, which begins to sound its alarm. The nurse sees no electrocardiographic complexes on the screen. Which is the priority nursing action? 1. Call a code. 2. Call the health care provider. 3. Check the client's status and lead placement. 4. Press the recorder button on the electrocardiogram console.

3. Check the client's status and lead placement.

The client has developed atrial fibrillation, with a ventricular rate of 150 beats/minute. The nurse should assess the client for which associated signs and/or symptoms? 1. Flat neck veins 2. Nausea and vomiting 3. Hypotension and dizziness 4. Hypertension and headache

3. Hypotension and dizziness

A client has sustained a closed fracture and has just had a cast applied to the affected arm. The client is complaining of intense pain. The nurse elevates the limb, applies an ice bag, and administers an analgesic, with little relief. Which problem may be causing this pain? 1. Infection under the cast 2. The anxiety of the client 3. Impaired tissue perfusion 4. The recent occurrence of the fracture

3. Impaired tissue perfusion

The client arrives in the emergency room with a penetrating eye injury from wood chips while cutting wood. The nurse assesses the eye and notes a piece of wood protruding from the eye, what is the initial nursing action? 1. Remove the piece of wood using a sterile eye clamp 2. Apply an eye patch 3. Perform visual acuity tests 4. Irrigate the eye with sterile saline.

3. Perform visual acuity tests

The nurse is assessing the casted extremity of a client. Which sign is indicative of infection? 1. Dependent edema 2. Diminished distal pulse 3. Presence of a "hot spot" on the cast 4. Coolness and pallor of the extremity

3. Presence of a "hot spot" on the cast

The nurse is evaluating a client in skeletal traction. When evaluating the pin sites, the nurse would be most concerned with which finding? 1. Redness around the pin sites 2. Pain on palpation at the pin sites 3. Thick, yellow drainage from the pin sites 4. Clear, watery drainage from the pin sites

3. Thick, yellow drainage from the pin sites

5. In caring for a victim of sexual assault, which task is most appropriate for an LPN/LVN? A. Provide emotional support and supportive communication. B. Assess immediate emotional state and physical injuries. C. Ensure that the "chain of custody" is maintained. D. Collect hair samples, saliva swabs, and scrapings beneath fingernails.

5. Answer: A. Provide emotional support and supportive communication.

A client has just been prescribed with Methotrexate (Trexall) for the treatment of rheumatoid arthritis who did not respond to any other treatment. An important reminder for the client is to? A. Clay-colored stool is a normal response of the treatment. B. Pregnancy is not contraindicated with the use of the medication. C. Strict hand washing. D. Get a daily source of sunlight during the day.

C. Strict hand washing.

The nurse in a medical unit is caring for a client with heart failure. The client suddenly develops extreme dyspnea, tachycardia, and lung crackles and the nurse suspects pulmonary edema. The nurse immediately asks another nurse to contact the health care provider and prepares to implement which priority interventions? Select all that apply. Administering oxygen Inserting a Foley catheter Administering furosemide Administering morphine sulfate intravenously Transporting the client to the coronary care unit Placing the client in a low Fowler's side-lying position

Administering oxygen Inserting a Foley catheter Administering furosemide Administering morphine sulfate intravenously

The client arrives in the emergency room after sustaining a chemical eye injury from a splash of battery acid. The initial nursing action is to: 1. Begin visual acuity testing 2. Irrigate the eye with sterile normal saline 3. Swab the eye with antibiotic ointment 4. Cover the eye with a pressure patch.

Irrigate the eye with sterile normal saline

Which cast care instructions should the nurse provide to a client who just had a plaster cast applied to the right forearm? Select all that apply. Keep the cast clean and dry. Allow the cast 24 to 72 hours to dry. Keep the cast and extremity elevated. Expect tingling and numbness in the extremity. Use a hair dryer set on a warm to hot setting to dry the cast. Use a soft, padded object that will fit under the cast to scratch the skin under the cast.

Keep the cast clean and dry. Allow the cast 24 to 72 hours to dry. Keep the cast and extremity elevated.

The nurse is caring for a client being treated for fat embolus after multiple fractures. Which data would the nurse evaluate as the most favorable indication of resolution of the fat embolus? 1. Clear mentation 2. Minimal dyspnea 3. Oxygen saturation of 85% 4. Arterial oxygen level of 78 mm Hg (10.3 kPa)

1. Clear mentation

Allopurinol is prescribed for a client and the nurse provides medication instructions to the client. Which instruction should the nurse provide? 1. Drink 3000 mL of fluid a day. 2. Take the medication on an empty stomach. 3. The effect of the medication will occur immediately. 4. Any swelling of the lips is a normal expected response.

1. Drink 3000 mL of fluid a day.

A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hour. The nurse determines that the client is receiving the therapeutic effect based on which results? 1. Prothrombin time of 12.5 seconds 2. Activated partial thromboplastin time of 60 seconds 3. Activated partial thromboplastin time of 28 seconds 4. Activated partial thromboplastin time longer than 120 seconds

2. Activated partial thromboplastin time of 60 seconds

A client who had cardiac surgery 24 hours ago has had a urine output averaging 20 mL/hour for 2 hours. The client received a single bolus of 500 mL of intravenous fluid. Urine output for the subsequent hour was 25 mL. Daily laboratory results indicate that the blood urea nitrogen level is 45 mg/dL (16 mmol/L) and the serum creatinine level is 2.2 mg/dL (194 mcmol/L). On the basis of these findings, the nurse would anticipate that the client is at risk for which problem? 1. Hypovolemia 2. Acute kidney injury 3. Glomerulonephritis 4. Urinary tract infection

2. Acute kidney injury

A client with a clot in the right atrium is receiving a heparin sodium infusion at 1000 units/hour and warfarin sodium 7.5 mg at 5:00 p.m. daily. The morning laboratory results are as follows: activated partial thromboplastin time (aPTT), 32 seconds; international normalized ratio (INR), 1.3. The nurse should take which action based on the client's laboratory results? 1. Collaborate with the health care provider (HCP) to discontinue the heparin infusion and administer the warfarin sodium as prescribed. 2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed. 3. Collaborate with the HCP to withhold the warfarin sodium since the client is receiving a heparin infusion and the aPTT is within the therapeutic range. 4. Collaborate with the HCP to continue the heparin infusion at the same rate and to discuss use of dabigatran etexilate in place of warfarin sodium.

2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed.

A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. Which finding would the nurse anticipate when auscultating the client's breath sounds? 1. Stridor 2. Crackles 3. Scattered rhonchi 4. Diminished breath sounds

2. Crackles

The nurse is monitoring a client who is taking digoxin for adverse effects. Which findings are characteristic of digoxin toxicity? Select all that apply. 1. Tremors 2. Diarrhea 3. Irritability 4. Blurred vision 5. Nausea and vomiting

2. Diarrhea 4. Blurred vision 5. Nausea and vomiting

The nurse has given instructions to a client returning home after knee arthroscopy. Which statement by the client indicates that the instructions are understood? 1. "I can resume regular exercise tomorrow." 2. "I can't eat food for the remainder of the day." 3. "I need to stay off the leg entirely for the rest of the day." 4. "I need to report a fever or swelling to my health care provider."

4. "I need to report a fever or swelling to my health care provider."

The nurse is assisting to defibrillate a client in ventricular fibrillation. After placing the pad on the client's chest and before discharge, which intervention is a priority? 1. Ensure that the client has been intubated. 2. Set the defibrillator to the "synchronize" mode. 3. Administer an amiodarone bolus intravenously. 4. Confirm that the rhythm is actually ventricular fibrillation.

4. Confirm that the rhythm is actually ventricular fibrillation.

The nurse is admitting a client with multiple trauma injuries to the nursing unit. The client has a leg fracture and had a plaster cast applied. Which position would be best for the casted leg? 1. Elevated for 3 hours, then flat for 1 hour 2. Flat for 3 hours, then elevated for 1 hour 3. Flat for 12 hours, then elevated for 12 hours 4. Elevated on pillows continuously for 24 to 48 hours

4. Elevated on pillows continuously for 24 to 48 hours

A client in sinus bradycardia, with a heart rate of 45 beats/minute, complains of dizziness and has a blood pressure of 82/60 mm Hg. Which prescription should the nurse anticipate will be prescribed? 1. Administer digoxin. 2. Defibrillate the client. 3. Continue to monitor the client. 4. Prepare for transcutaneous pacing.

4. Prepare for transcutaneous pacing.

A client with a hip fracture asks the nurse about Buck's (extension) traction that is being applied before surgery and what is involved. The nurse should provide which information to the client? 1. Allows bony healing to begin before surgery and involves pins and screws 2. Provides rigid immobilization of the fracture site and involves pulleys and wheels 3. Lengthens the fractured leg to prevent severing of blood vessels and involves pins and screws 4. Provides comfort by reducing muscle spasms, provides fracture immobilization, and involves pulleys and wheels

4. Provides comfort by reducing muscle spasms, provides fracture immobilization, and involves pulleys and wheels

A client with diabetes mellitus has had a right below-knee amputation. Given the client's history of diabetes mellitus, which complication is the client at most risk for after surgery? 1. Hemorrhage 2. Edema of the residual limb 3. Slight redness of the incision 4. Separation of the wound edges

4. Separation of the wound edges

The nurse witnessed a vehicle hit a pedestrian. The victim is dazed and tries to get up. A leg appears fractured. Which intervention should the nurse take? 1. Try to reduce the fracture manually. 2. Assist the victim to get up and walk to the sidewalk. 3. Leave the victim for a few moments to call an ambulance. 4. Stay with the victim and encourage him or her to remain still.

4. Stay with the victim and encourage him or her to remain still.

An intoxicated client comes into the emergency unit with an uncooperative behavior, mild confusion, and with slurred speech. The client is unable to provide a good history but he verbalizes that he has been drinking a lot. Which of the following is a priority action of the nurse? A. Administer IV fluid incorporated with Vitamin B1 as ordered. B. Administer Naloxone (Narcan) 4 mg as ordered. C. Contact the family to get information of the client. D. Obtain an order for the determination of blood alcohol level.

A. Administer IV fluid incorporated with Vitamin B1 as ordered.

After being hospitalized for 3 days with a right femur fracture, a 32-year-old patient suddenly develops shortness of breath and tachypnea. The patient tells the nurse, "I feel like I am going to die!" Which action should the nurse take first?

Administer the prescribed PRN oxygen at 4 L/min.

Which nursing intervention will be included in the plan of care after a patient with a right femur fracture has a hip spica cast applied?

Ask the patient about abdominal discomfort.

A group of people arrived at the emergency unit by a private car with complaints of periorbital swelling, cough, and tightness in the throat. There is a strong odor emanating from their clothes. They report exposure to a "gas bomb" that was set off in the house. What is the priority action? A. Direct the clients to the decontamination area. B. Direct the clients to the cold or clean zone for immediate treatment. C. Measure vital signs and auscultate lung sounds. D. Immediately remove other clients and visitors from the area. E. Instruct personnel to don personal protective equipment.

Answer: A. Direct the clients to the decontamination area.

A 36-year-old patient with a history of seizures and medication compliance of phenytoin (Dilantin) and carbamazepine (Tegretol) is brought to the ED by the MS personnel for repetitive seizure activity that started 45 minutes prior to arrival. You anticipate that the physician will order which drug for status epilepticus? A. Lorazepam (Ativan) IV. B. Magnesium sulfate IV. C. Carbamazepine (Tegretol) IV. D. Phenytoin and Carbamazepine PO.

Answer: A. Lorazepam (Ativan) IV.

Nurse Ejay is assigned to a telephone triage. A client called who was stung by a honeybee and is asking for help. The client reports of pain and localized swelling but has no respiratory distress or other symptoms of anaphylactic shock. What is the appropriate initial action that the nurse should direct the client to perform? A. Removing the stinger by scraping it. B. Applying a cold compress. C. Taking an oral antihistamine. D. Calling the 911.

Answer: A. Removing the stinger by scraping it.

After exposure to hot weather and sun, clients with signs and symptoms of heat-related ailment rush to the Emergency Department (ED). Sort clients into those who need critical attention and those with less serious condition. 1. An abandoned person who is a teacher; has altered mental state, weak muscle movement, hot, dry, pale skin; and whose duration of heat exposure is unknown. 2. An elderly traffic enforcer who complains of dizziness and syncope after standing under the heat of the sun for several hours to perform his job. 3. A comparatively healthy housewife who states that the air conditioner has been down for 5 days and who exhibits hypotension, tachypnea, profuse diaphoresis, and fatigue. 4. A sportsman who complains of severe leg cramps and nausea, and displays paleness, tachycardia, weakness, and diaphoresis. A. 4, 3, 2, 1 B. 1, 2, 4, 3 C. 1, 4, 2, 3 D. 4, 1, 3, 2

Answer: B. 1, 2, 4, 3

Nurse Anna is an experienced travel nurse who was recently employed and is assigned in the emergency unit. In her first week of the job, which of the following area is the most appropriate assignment for her? A. Triage. B. Ambulatory section. C. Trauma team. D. Psychiatric care

Answer: B. Ambulatory section.

When an unexpected death occurs in the emergency department, which task is the most appropriate to delegate to a nursing assistant? A. Help the family to collect belongings. B. Assisting with postmortem care. C. Facilitate meeting between the family and the organ donor specialist. D. Escorting the family to a place of privacy.

Answer: B. Assisting with postmortem care.

The nursing manager decides to form a committee to address the issue of violence against ED personnel. Which combination of employees would be best suited to fulfill this assignment? A. RNs, LPNs, and nursing assistants. B. At least one representative from each group of ED personnel. C. Experienced RNs and experienced paramedics. D. ED physicians and charge nurses.

Answer: B. At least one representative from each group of ED personnel.

A client arrives in the emergency unit and reports that a concentrated household cleaner was splashed in both eyes. Which of the following nursing actions is a priority? A. Use Restasis (Allergan) drops in the eye. B. Flush the eye repeatedly using sterile normal saline. C. Examine the client's visual acuity. D. Patch the eye.

Answer: B. Flush the eye repeatedly using sterile normal saline.

A 5-year-old client was admitted to the emergency unit due to ingestion of unknown amount of chewable vitamins for children at an unknown time. Upon assessment, the child is alert and with no symptoms. Which of the following information should be reported to the physician immediately? A. The child has been treated multiple times for injuries caused by accidents. B. The vitamin that was ingested contains iron. C. The child was nauseated and vomited once at home. D. The child has been treated several times for toxic substance ingestion.

Answer: B. The vitamin that was ingested contains iron.

The following clients come at the emergency department complaining of acute abdominal pain. Prioritize them for care in order of the severity of the conditions. 1. A 27-year-old woman complaining of lightheadedness and severe sharp left lower quadrant pain who reports she is possibly pregnant. 2. A 43-year-old woman with moderate right upper quadrant pain who has vomited small amounts of yellow bile and whose symptoms have worsened over the week. 3. A 15-year-old boy with a low-grade fever, right lower quadrant pain, vomiting, nausea, and loss of appetite for the past few days. 4. A 57-year-old woman who complains of a sore throat and gnawing midepigastric pain that is worse between meals and during the night. 5. A 59-year-old man with a pulsating abdominal mass and sudden onset of persistent abdominal or back pain, which can be described as a tearing sensation within the past hour. A. 2,5,3,4,1 B. 3,1,4,5,2 C. 5,1,3,2,4 D. 2,5,1,4,3

Answer: C. 5,1,3,2,4

A client arrives at the emergency department who suffered multiple injuries from a head-on car collision. Which of the following assessment should take the highest priority to take? A. Irregular pulse. B. Ecchymosis in the flank area. C. A deviated trachea. D. Unequal pupils.

Answer: C. A deviated trachea.

The following clients are presented with signs and symptoms of heat-related illness. Which of them needs to be attended first? A. A relatively healthy homemaker who reports that the air conditioner has been broken for days and who manifest fatigue, hypotension, tachypnea, and profuse sweating. B. An elderly person who complains of dizziness and syncope after standing in the sun for several hours to view a parade. C. A homeless person who is a poor historian; has altered mental status, poor muscle coordination, and hot, dry ashen skin; and whose duration of heat exposure is unknown. D. A marathon runner who complains of severe leg cramps and nausea, and manifests weakness, pallor, diaphoresis, and tachycardia.

Answer: C. A homeless person who is a poor historian; has altered mental status, poor muscle coordination, and hot, dry ashen skin; and whose duration of heat exposure is unknown.

The physician has ordered cooling measures for a child with a fever who is likely to be discharged when the temperature comes down. Which task would be appropriate to delegate to a nursing assistant? A. Prepare and administer a tepid sponge bath. B. Explain the need for giving cool fluids. C. Assist the child in removing outer clothing. D. Advise the parent to use acetaminophen (Tylenol) instead of aspirin.

Answer: C. Assist the child in removing outer clothing.

In the work setting, what is the primary responsibility of the nurse in preparation for disaster management, that includes natural disasters and bioterrorism incidents? A. Being aware of the signs and symptoms of potential agents of bioterrorism. B. Making ethical decisions regarding exposing self to potentially lethal substances. C. Being aware of the agency's emergency response plan. D. Being aware of what and how to report to the Centers for Disease Control and Prevention.

Answer: C. Being aware of the agency's emergency response plan.

The emergency medical service has transported a client with severe chest pain. As the client is being transferred to the emergency stretcher, you note unresponsiveness, cessation of breathing, and unpalpable pulse. Which of the following task is appropriate to delegate to the nursing assistant? A. Assisting with the intubation. B. Placing the defibrillator pads. C. Doing chest compressions. D. Initiating bag valve mask ventilation.

Answer: C. Doing chest compressions.

Nurse Kelly, a triage nurse encountered a client who complaints of mid-sternal chest pain, dizziness, and diaphoresis. Which of the following nursing action should take priority? A. Complete history taking. B. Put the client on ECG monitoring. C. Notify the physician. D. Administer oxygen therapy via nasal cannula.

Answer: D. Administer oxygen therapy via nasal cannula.

A nurse is providing discharge instruction to a woman who has been treated for contusions and bruises due to a domestic violence. What is the priority intervention for this client? A. Making a referral to a counselor. B. Making an appointment to follow up on the injuries. C. Advising the client about contacting the police. D. Arranging transportation to a safe house.

Answer: D. Arranging transportation to a safe house.

In conducting a primary survey on a trauma patient, which of the following is considered one of the priority elements of the primary survey? A. Initiation of pulse oximetry. B. Complete set of vital signs. C. Client's allergy history. D. Brief neurologic assessment.

Answer: D. Brief neurologic assessment.

A client was brought to the emergency department after suffering a closed head injury and lacerations around the face due to a hit-run accident. The client is unconscious and has minimal response to noxious stimuli. Which of the following assessment findings if observed after few hours, should be reported to the physician immediately? A. Bleeding around the lacerations. B. Withdrawal of the client in response to painful stimuli. C. Bruises and minimal edema of the eyelids. D. Drainage of a clear fluid from the client's nose.

Answer: D. Drainage of a clear fluid from the client's nose.

An anxious female client complains of chest tightness, tingling sensations, and palpitations. Deep, rapid breathing, and carpal spasms are noted. Which of the following priority action should the nurse do first? A. Provide oxygen therapy. B. Notify the physician immediately. C. Administer anxiolytic medication as ordered. D. Have the client breathe into a brown paper bag.

Answer: D. Have the client breathe into a brown paper bag.

When attending a client with a head and neck trauma following a vehicular accident, the nurse's initial action is to? A. Do oral and nasal suctioning. B. Provide oxygen therapy. C. Initiate intravenous access. D. Immobilize the cervical area.

Answer: D. Immobilize the cervical area.

You are preparing a child for IV conscious sedation before the repair of a facial laceration. What information should you report immediately to the physician? A. The parent wants information about the IV conscious sedation. B. The parent is not sure regarding the child's tetanus immunization status. C. The child suddenly pulls out the IV. D. The parent's refusal of the administration of the IV sedation.

Answer: D. The parent's refusal of the administration of the IV sedation.

A client suffered an amputation of the first and second digits in a chainsaw accident. Which task should be delegated to an LPN/LVN? A. Cleansing the amputated digits and placing them directly into an ice slurry. B. Cleansing the digits with sterile normal saline and placing in a sterile cup with sterile normal saline. C. Gently cleansing the amputated digits and the hand with povidone-iodine. D. Wrapping the cleansed digits in saline-moistened gauze, sealing in a plastic container, and placing it in an ice.

Answer: D. Wrapping the cleansed digits in saline-moistened gauze, sealing in a plastic container, and placing it in an ice.

After change-of-shift report, which patient should the nurse assess first?

Patient with right femoral shaft fracture whose thigh is swollen and ecchymotic

The purpose of adding PEEP to positive pressure ventilation is to a.increase functional residual capacity and improve oxygenation. b.increase FIO2 in an attempt to wean the patient and avoid O2 toxicity. c.determine if the patient is in synchrony with the ventilator or needs to be paralyzed. d.determine if the patient is able to be weaned and avoid the risk of pneumomediastinum.

a..increase functional residual capacity and improve oxygenation.

A patient has a core temperature of 90° F (32.2° C). The most appropriate rewarming technique would be a.passive rewarming with warm blankets. b.active internal rewarming using warmed IV fluids. c.passive rewarming using air-filled warming blankets. d.active external rewarming by submersing in a warm bath.

b.active internal rewarming using warmed IV fluids.

The nurse monitors the patient with positive pressure mechanical ventilation for a.paralytic ileus because pressure on the abdominal contents affects bowel motility. b.diuresis and sodium depletion because of increased release of atrial natriuretic peptide. c.signs of cardiovascular insufficiency because pressure in the chest impedes venous return. d.respiratory acidosis in a patient with COPD because of alveolar hyperventilation and increased PaO2 levels.

c.signs of cardiovascular insufficiency because pressure in the chest impedes venous return.

A pedestrian who was hit by a car is admitted to the emergency department with possible right lower leg fractures. The initial action by the nurse should be to

check the pedal pulses.


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