ATI RN Fundamentals A nurse is caring for a client who has a surgical wound. Which of the following
... [Show More] laboratory
values places the client at risk for poor wound healing?
a. Serum albumin 3 g/dL
b. Total lymphocyte count 2400 mm3
c. HCT 42%
d. HGB 16g/dL
◗ Rationale: Albumin in low. Normal range is 3.5 to 5.5 g/dL. Low albumin places the
client at risk forpoor wound healing. The other lab values are within normal limits.
A nurse is preparing to check a client's blood pressure. Which of the following actions should
the nurse take? Chapter 27 Vitals signs page 244
a. Apply the cuff above the client’s antecubital fossa.
b. Use a cuff with a width that is about 60% of the client's arm circumference. - width of the
cuff should be 40 % of arm circumference
c. How the clients sit with his arm resting above the level of his heart. - MUST BE AT
HEART LEVEL
d. Release the pressure on the client's arm 5 to 6 mm per second. - pressure release should
not be more than 2 to 3 mm hg per second
◗ Rationale: ATI FUNDA says 40% of the arm circumference pg. 139. Release the pressure
no faster than 2 to 3 mm Hg per second. Apply the BP cuff 2.5 cm (1 in) above the antecubital
space with the brachial artery in line with the marking on the cuff.Apply the BP cuff 2.5 cm (1
in) above the antecubital space with the brachial artery in line with the marking on the cuff.
A nurse is preparing to perform nasal tracheal suctioning for a client. Which of the following is
an appropriate action for the nurse to take? Chapter 53 Airway management page 563
a. Hold the suction catheter with the clean non-dominant hand.
b. Apply suctioning for 20 to 30 seconds.- 10 -15 seconds is the maximum.
c. Place the catheter in a location that is clean and dry for later use new line.- NEVER
EVER REUSE THE SUCTION CATHETER . you throw it away after being used.
d. Use surgical asepsis when performing the procedure.- book say medical asepsis which is
maybe the same thing [Show Less]