The nurse cares for a 55-year-old female admitted to the burn unit following a house fire.    Nurses’ Notes    2000: A 55- year-old female arrives to the emergency department via ambulance with bilateral second and third degree burns to the front lower extremities from a house fire that occurred at 1800 today. Burns estimated at 36% of total body surface area. Client weighs 220 lbs.   2100:  Admitted to the burn unit. Vital signs as noted. Morphine sulfate given for pain.  Wound care was provided by the nurse.  Breath sounds clear.  Bilateral +2 pitting edema was noted in the lower extremities. Doppler pedal pulses present.  Vital Signs    Time  2000  2100  Temperature  37.8 C/100 F  37.5 C/99.5 F  Heart rate  130  135  Respirations  28  32  Blood pressure  88/58  80/54  Pulse oximeter  95 on 4L NC  92 on 4L NC  Pain  6/10  4/10  Intake & Output     Fluid resuscitation order: 4 mL Ringer’s lactate x kilogram weight x body surface burned. Give the first half within the first 24 hours and the remaining over the next 16 hours.     Hour  2000  2100  Fluids in the field  1200 mL/hr  1200 mL/hr  Output    20 mL      44a. Choose the four assessment findings that are the nurse’s priority concerns for this patient.  Respirations Pitting edema Blood pressure Urine output Heart rate Temperature Pulse oximeter Pain     44b. What is the importance of these assessment findings? (what is occurring?) 

A chest tube is placed for a patient with pneumothorax. Which of the following is a critical action in managing the chest tube? 

A client with a suspected pulmonary embolism (PE) is undergoing diagnostic testing. Which of the following findings is most indicative of a PE? 

INSTRUCTIONS:  Calculate the following dosage problems and show your work on the test.  You may use your calculator.  Clearly fill-in only one answer for each question.  Fill in the blank with your answer.    INSTRUCTIONS FOR ROUNDING OFF NUMBERS:  1) Round off gtts / min to the nearest whole number.  EXAMPLES:  16.7 gtts / min = 17 gtts / min  OR  14.2 gtts / min = 14 gtts / min  2) Round off answers LESS than 1 to 2 decimal points (hundredths).  EXAMPLES:  0.035 = 0.04  OR  0.201 = 0.20  3) Round off answers GREATER than 1 to 1 decimal point (tenths).  EXAMPLES:  1.65 = 1.7  OR  1.23 = 1.2  4) Round off mL / hr to the nearest whole number.  EXAMPLES:  1.4 mL / hr = 1 mL / hr   OR   1.6 mL / hr = 2 mL / hr  5) Round off weights in Kg to one decimal point (tenths).  EXAMPLES:  30.46 Kg = 30.5 Kg  OR  22.32 Kg = 22.3 Kg  ______________________________________________________________________    The provider orders dobutamine at 12mcg/kg/min for Mrs. White, who weighs 165 pounds. The concentration is dobutamine 1G in 250 mL of D5W. How many milliliters per hour (mL/Hr) should the IV pump be programmed for?  mL/Hr 

A nurse is caring for a client who has hypovolemic shock. Which of the following should the nurse recognize as an expected finding? 

A client presents to the clinic with an epistaxis. The nurse instructs the client to sit down and lean forward slightly. What is the rationale behind this position? 

A nurse is assessing a client with suspected tuberculosis. Which of the following findings are indicative of TB? Select all that apply  

A client with tuberculosis (TB) is prescribed isoniazid. What additional measure should the nurse recommend to prevent side effects associated with this medication? 

  A client with a history of chronic obstructive pulmonary disease presents with shortness of breath and an ABG showing the following values: pH: 7.32, PaCO2: 55, HCO3: 24. What is the priority nursing intervention?  

In managing a patient with ARDS who is not responding well to conventional ventilation strategies, what intervention might be considered to improve oxygenation?