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A client receives a prescription for ophthalmic ketorolac. Prior to administering the medication, the nurse should review the medical record for which condition?

The nurse is planning care for a client with a direct (sliding) hiatal hernia. Nursing actions should be planned to meet which goal?

A client with chronic cirrhosis has esophageal varices. It is most important for the nurse to monitor the client for the onset of which problem?

Exhibit 1: History and Physical

The client is a 51-year-old male admitted to the medical floor with a diagnosis of pneumonia. He reports a 3-day history of productive cough, shortness of breath, and fever. He also mentions increased fatigue and weakness over the last week. The client has a history of hypertension, which is controlled with enalapril 10 mg daily. His surgical history includes adenoidectomy at age 5 and surgical repair of a fractured femur at age 20. The client takes a multivitamin daily and has no known allergies. He is a non-smoker and reports occasional alcohol use.

Exhibit 2: Nurse's Notes (0800)

At 0800, the client was alert but appeared fatigued and short of breath. His oxygen saturation was 89% on room air, and he was placed on supplemental oxygen at 10 L/min via nasal cannula, which improved his saturation to 94%. The client stated, “I feel tired and weak, and it’s hard to breathe.” His skin was warm to the touch, and he had a productive cough with thick, yellow sputum. He reported a headache and body aches, rating his pain as 4/10. The client denied chest pain but reported feeling feverish throughout the night. His capillary refill was less than 3 seconds, and lung sounds were diminished with crackles heard bilaterally.

Exhibit 3: Vital Signs

• Time: 0800
• Temperature: 101.2°F (38.4°C)
• Pulse: 112 beats per minute
• Respiratory Rate: 28 breaths per minute
• Blood Pressure: 150/92 mmHg
• Oxygen Saturation: 89% on room air, 94% on 10 L/min nasal cannula

Exhibit 4: Physical Examination Results

Upon physical examination, the client appeared ill and was in mild respiratory distress, with shallow and rapid breathing. His skin was warm and flushed, and he was diaphoretic. Lung auscultation revealed bilateral crackles in the lower lobes, more pronounced on the right side. There were no wheezes or rhonchi noted. His heart sounds were regular, but tachycardia was present. The client’s abdomen was soft and non-tender with normal bowel sounds. No edema was noted in the extremities, and there were no visible rashes or skin abnormalities. The client’s capillary refill was normal, and neurological assessment showed no focal deficits.

Exhibit 5: Provider's Prescriptions

1. Admit to the medical floor
2. Vital signs every 4 hours
3. Continuous pulse oximetry
4. Supplemental oxygen 10 L/min via nasal cannula
5. Enalapril 10 mg PO every morning
6. Ibuprofen 400 mg PO every 4 to 6 hours PRN for temperature greater than 100.5°F (38.0°C)
7. Send blood for complete blood count and electrolytes
8. Chest X-ray now

Question: Which of the following provider's prescriptions would the nurse question? Select all that apply.

A client with open-angle glaucoma asks the nurse how long the prescribed eye drops will need to be used. Which response made by the nurse is accurate?

A client who was admitted yesterday with bilateral pneumonia has congested breath sounds, an oxygen saturation of 94%, a weak cough effort, and is using accessory muscles to breathe. Which intervention should the nurse implement first?

The nurse notes that a client has been receiving hydromorphone every six hours for four days. Which assessment is most important for the nurse to complete?

Following discharge teaching, a client with a duodenal ulcer tells the nurse of plans to eat plenty of dairy products to help coat and protect the duodenal ulcer. Which is the best follow-up action by the nurse?

A client is being cared for in the emergency department with acute abdominal pain and a provisional diagnosis of pancreatitis. Which information is most valuable in reporting the client’s status to the healthcare provider?

A client has a nasogastric (NG) tube placed during abdominal surgery. During postoperative convalescence, which arterial blood gas values are consistent with metabolic alkalosis?

The nurse is preparing a teaching plan for a group of well-educated clients who were found to be HIV positive within the last year. The nurse should explain that the human immunodeficiency virus (HIV) acts in which way to suppress the immune system?