A nurse is preparing to perform a wet-to-dry dressing change for a client who has an infected abdominal wound.

Which of the following techniques should the nurse use when performing this dressing change?

- Remove the tape by pulling from the center of the dressing.
- Wear sterile gloves to remove the dressing.
- Clean the wound from the center to the outer edges.
- Moisten the dressing before removal.

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A nurse is assisting in the care of a newly admitted client.

History and Physical Day 1 0800:
- Client admitted for epigastric abdominal pain.
- Client rates pain as 8 on a 0 to 10 scale.
- Client states pain began 24 hr after drinking alcohol and eating a large meal.
- Client has a history of alcohol use disorder.
- Client indicated no relief of pain after taking cimetidine.
- Client is alert and oriented to person, place, and time.
- Lung sounds diminished in the bases bilaterally.
- Bowel sounds hypoactive in all four quadrants, abdomen distended.
- Client reports nausea and vomiting for the past 24 hr.

Which of the following findings should the nurse report immediately to the provider? (Select all that apply.)
- Blood pressure
- Urine output
- Cold, clammy skin
- Respiratory status
- Serum amylase level
- Sodium level
- Temperature
- Heart rate
- Mental confusion
- Pain

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A nurse is assisting in the care of an older adult client who was admitted from a long-term care facility.

Select the 3 findings that require immediate follow-up.

Vital Signs 1500:
- Temperature 38.4 °C (101.2 °F)
- Heart rate 104/min
- Respiratory rate 30/min
- Blood pressure 108/62 mm Hg
- Oxygen saturation 89% on room air

- Oxygen saturation level
- Tremors
- Respiratory rate
- Heart rate
- Current level of consciousness
- Chronic health condition

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A nurse is providing a change-of-shift report for a client.

Which of the following information should the nurse include in the report?
- "The client's partner visited earlier today for 2 hours."
- "The client received the prescribed antibiotic every 8 hours."
- "The client reports pain is reduced when he is positioned on his side."
- "The client's mother died 4 years ago from breast cancer."

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A community health nurse is developing a brochure about hypertension.

Which of the following actions should the nurse take?
- Write the information at an 8th-grade reading level.
- Present information from complex to simple.
- Explain medical terminology using basic, one-syllable words.
- Use a 12-point font size.

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A nurse is caring for a client who is cyanotic and has a respiratory rate of 8/min with shallow respirations.

Which of the following is the priority action by the nurse?
- Establish a patent airway for the client.
- Administer oxygen to the client.
- Place a pulse oximeter on the client's finger.
- Check the client's pulse rate.

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A nurse is participating in an interprofessional team meeting for a client.

Which of the following information about the client should the nurse include?
- The client's vital signs are checked every 8 hr.
- The client's next dressing change is scheduled in 4 hr.
- The client has state-sponsored health insurance.
- The client has developed difficulty ambulating.

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A nurse is reinforcing discharge teaching with a client who has stable angina pectoris.

Which of the following statements by the client indicates an understanding of what to do when chest pain occurs?
- "I will call the provider after taking one dose of nitroglycerin."
- "I will hold my breath and bear down."
- "I will stop what I am doing and lie down."
- "I will take two 325 milligram aspirin tablets at the same time."

This response reflects the appropriate action for relieving chest pain and minimizing cardiac workload please note that these answers and explanations are provided based on the context you've provided if you have any further questions or need additional explanations, feel free to ask.

It seems like you have provided a set of multiple-choice questions related to nursing scenarios.

You've also asked for specific information from each question.

Let me help you by providing the answers and explanations for each question:

Wet-to-Dry Dressing Change Technique: The nurse should not moisten the dressing before removal because wet-to-dry dressings are intended to aid in wound debridement by allowing the dressing to adhere to wound debris.

Therefore, the correct technique is to remove the tape by pulling from the center of the dressing.

Immediate Reportable Findings for Newly Admitted Client: The nurse should report the following findings immediately to the provider: Cold, clammy skin (indicative of poor perfusion), Respiratory status (diminished lung sounds and hypoactive bowel sounds, indicating potential complications), Mental confusion (could indicate underlying issues).

Immediate Follow-Up Findings for Older Adult Client: The findings that require immediate follow-up for an older adult client include: Elevated temperature (possible infection), Oxygen saturation level (low saturation may indicate respiratory distress), Tremors (could be a sign of medication side effects).

Information to Include in Change-of-Shift Report: The nurse should include the information that "The client's partner visited earlier today for 2 hours."

This information is relevant to the client's social and emotional well-being.

Developing a Brochure about Hypertension: The nurse should write the information at an 8th-grade reading level to ensure that the content is understandable to a broad audience.

Priority Action for Cyanotic Client with Low Respiratory Rate: The priority action by the nurse is to establish a patent airway for the client to ensure adequate oxygenation.

Information to Include in Interprofessional Team Meeting: The nurse should include the information that "The client has developed difficulty ambulating."

This information is pertinent to the client's mobility and potential rehabilitation needs.

Discharge Teaching for Stable Angina Pectoris: The statement that indicates an understanding of what to do when chest pain occurs is "I will stop what I am doing and lie down."

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