Difficulty: Medium
Average Score: 93%
Simulated
Passage / Scenario
Medical HistoryClient reports an injury to their right ribs after falling 6 feet from a ladder. Client reports pain as 8 on a scale of 0 to 10 over the right lower rib cage with ecchymosis. Client is dyspneic and respirations are shallow. Client states, "It's hard for me to breathe."
Nurses' Notes
Client appears anxious and tachypneic. Respirations are labored and shallow. Lung sounds absent in the right lower lobe. Skin is cool and slightly cyanotic.
Vital Signs
Temperature 36.2┬░ C (98.4┬░ F) Pulse 120/min; regular
Respiratory rate 38/min
Blood pressure 92/64 mm Hg
O saturation 85% on room air
A nurse is reviewing the client's medical record. Which of the following prescriptions should the nurse anticipate for a client who has a pneumothorax? For each potential provider's prescription, click to specify if the potential prescription is anticipated, non-essential, or contraindicated for the client.
Correct answer
A,D,E,F
Rationale
IV access, chest tube insertion, ABGs, and CT of the chest are anticipated to manage and diagnose the extent of the pneumothorax.