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Author Archives: Anonymous

The client post-thyroidectomy complains of numbness and ting…

The client post-thyroidectomy complains of numbness and tingling around the mouth and the tips of the fingers.  Which intervention should the nurse implement first?

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The nurse is caring for a patient with end-stage liver disea…

The nurse is caring for a patient with end-stage liver disease who has massive ascites and requires paracentesis to remove 4 liters of fluid. Which intervention should the nurse anticipate immediately following the procedure?  

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While administering IV medication through a PICC using an in…

While administering IV medication through a PICC using an infusion pump, the patient reports sudden chest fluttering, dizziness, and a metallic taste. The nurse notes the external catheter length is shorter than previously documented. What is the nurse’s priority action?

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A patient is receiving propofol for conscious sedation durin…

A patient is receiving propofol for conscious sedation during an endoscopic procedure. Which nursing assessment finding requires immediate intervention?

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The nurse is preparing to start an IV on an infant admitted…

The nurse is preparing to start an IV on an infant admitted to the pediatric unit. Which intervention is most appropriate?

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The nurse notices that the mother of a child with cerebral p…

The nurse notices that the mother of a child with cerebral palsy frequently corrects and redoes many of the nursing interventions provided to her child. What is the nurse’s most appropriate response?

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The nurse is caring for a patient 6 hours after abdominal su…

The nurse is caring for a patient 6 hours after abdominal surgery. Which findings indicate the patient may be developing hemorrhage and hypovolemic shock? (Select all that apply.)  

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A patient received succinylcholine during surgery. Thirty mi…

A patient received succinylcholine during surgery. Thirty minutes after arrival in the PACU, the patient develops cola-colored urine, a rapidly rising temperature, and increasing heart rate despite cooling measures. Which additional assessment findings would the nurse expect? 

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A patient is scheduled for an elective laparoscopic cholecys…

A patient is scheduled for an elective laparoscopic cholecystectomy tomorrow morning. The surgeon estimates blood loss will be minimal. The preoperative nurse receives an order that states “Type and screen.” What is the primary purpose of this order?  

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A 4-year-old child tearfully asks the nurse if an intramuscu…

A 4-year-old child tearfully asks the nurse if an intramuscular injection will hurt. What is the nurse’s most effective response?

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