1. A nurse is caring for a client who has been sitting in a chair for 3 hr. Which of the following is the client at risk for developing? C. Pressure ulcer
2. Which of the following nursing interventions should be implemented to maintain a patent airway in a client on bed rest? D. Teach to use an incentive spirometer while awake.
3. Which of the following nursing interventions reduce the risk of thrombus development? (Select all that apply.) ( ) Teach the client not to use Valsalva maneuver. (X) Apply elastic stockings ( ) Review laboratory values for total protein level ( ) Place pillow under client's knees and lower (X) Assist the client to change position often
4. Which of the following clients would benefit from the application of cold? (Select all that apply.) (X) A client who has a sprained ankle ( ) A client who has Raynaud's phenomenon (X) A client who just had knee arthroplasty (X) A client who has a toothache (X) A client who has a nosebleed
5. Sequential compression devices are used to B. Promote venous return.
6. Identify the order in which the following steps of elastic stocking application should be completed. 1. Perform hand hygiene. 7. Smooth any creases or wrinkles. 6. Pull the remainder of the stocking over the client's heel and on up his leg. 4. Turn the stocking inside to the heel. 2. Assess the condition of the client's skin and the circulation of his legs. 5. Put the stocking on the client's foot. 3. Measure the client's calf and/ or thigh circumference and length of the leg, and select the correct size stocking.
Chapter 56 ATI questions
1. A nurse is collecting data from an older adult client who states he has had vomiting and diarrhea for the last 48 hr. which of the following findings should indicate to the nurse that the client is hypovolemic? (Select all that apply.) ( ) Bradycardia ( ) Hypertension (X) Tachypnea (X) Furrowed tongue (X)