The nurse is caring for four clients who had arterial blood gases (ABGs). Which laboratory value warrants immediate intervention by the nurse?
a. HCO3– of 25 mEq/L
b. SpO2 of 96%
c. pH of 7.38
d. PaCO2 of 48 mm Hg
D
Although the nurse should note the results of all laboratory work, only a PaCO2 of 48 mm Hg is likely to culminate in serious symptoms for the client. HCO3–, SpO2, and pH levels as assessed would not be life threatening, nor would they be indicative of serious complications that would override the importance of the PaCO2 level.
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Which factor is most responsible for differences in an individual's health?
a. Culture of the majority of the community's citizens b. Individual's education and income c. Number of physicians and other health care providers in the community d. Quality of the community health agency and hospital in the community
A client believes doorknobs are "filthy" with bacteria, and he must clean each knob three times
before he can touch it or must use a paper towel to avoid putting his fingers in contact with the knob. The nurse must make the assessment that this behavior serves the purpose of reducing a. sexual ideation. b. anxiety. c. guilt. d. hallucinations.
A client has been prescribed tretinoin (Retin-A). What will the nurse include in the client teaching?(Select all that apply.)
1. "Do not use this medication if pregnant." 2. "Avoid using vitamin C supplements." 3. "Increase intake of vitamin A." 4. "Avoid exposure to the sun." 5. "Do not take with oral contraceptives."
Which of the following findings in a patient with decreased cardiac output would the nurse recognize as indicating that interventions are effective, and the patient is improving? (Select all that apply.)
a. Temperature 98.6°F (37°C), respirations 16/min, blood pressure 110/75 mm Hg, pulse 75 beats/min) b. Urine output greater than 30 mL/hour c. Cool pale extremities with diminished peripheral pulses d. Less shivering e. Clear lung sounds f. Pulse oximeter reading 96%