Difficulty: Medium
Average Score: 80%
Simulated
Passage / Scenario
Vital SignsMedical History
Nurses' Notes
1000:
Temperature 36┬░ C (96.8┬░ F)
Blood pressure 118/56 mm Hg
Heart rate 92/min
Respiratory rate 18/min
Oxygen saturation 95% on room air
1200:
Temperature 37.2┬░ C (99┬░ F)
Blood pressure 104/56 mm Hg
Heart rate 62/min
Respiratory rate 12/min
Oxygen saturation 94% on room air
The client is most at risk of developing ___ and ___
Correct answer
D,E
Rationale
Parameters:
Correct Answer: (0, 0, 0, 1, 1, 0, 0)
Rationale:
- Atelectasis is a condition where the lungs do not expand fully, increasing the risk of respiratory complications.
- Paralytic ileus is a condition where the intestines stop working, leading to potential bowel obstruction.
- Urinary tract infection, delayed wound healing, and deep vein thrombosis are not directly related to the client's risk factors in this scenario.
Correct Answer: (0, 0, 0, 1, 1, 0, 0)
Rationale:
- Atelectasis is a condition where the lungs do not expand fully, increasing the risk of respiratory complications.
- Paralytic ileus is a condition where the intestines stop working, leading to potential bowel obstruction.
- Urinary tract infection, delayed wound healing, and deep vein thrombosis are not directly related to the client's risk factors in this scenario.