The nurse cares for a 55-year-old female admitted to the burn unit following a house fire.    Nurses’ Notes    2000: A 55- year-old female arrives to the emergency department via ambulance with bilateral second and third degree burns to the front lower extremities from a house fire that occurred at 1800 today. Burns estimated at 36% of total body surface area. Client weighs 220 lbs.   2100:  Admitted to the burn unit. Vital signs as noted. Morphine sulfate given for pain.  Wound care was provided by the nurse.  Breath sounds clear.  Bilateral +2 pitting edema was noted in the lower extremities. Doppler pedal pulses present.  Vital Signs    Time  2000  2100  Temperature  37.8 C/100 F  37.5 C/99.5 F  Heart rate  130  135  Respirations  28  32  Blood pressure  88/58  80/54  Pulse oximeter  95 on 4L NC  92 on 4L NC  Pain  6/10  4/10  Intake & Output     Fluid resuscitation order: 4 mL Ringer’s lactate x kilogram weight x body surface burned. Give the first half within the first 24 hours and the remaining over the next 16 hours.     Hour  2000  2100  Fluids in the field  1200 mL/hr  1200 mL/hr  Output    20 mL        What should the nurse set the IV pump at to deliver the first 8 hours of fluid resuscitation for this patient according to the ordered fluid resuscitation order? ____  mL/hr   

A client has a central venous catheter (CVC) inserted for long-term antibiotic therapy. The nurse is reviewing the care plan to reduce the risk of central line–associated bloodstream infections (CLABSIs). Which nursing action is most appropriate to include in the plan?

A client has partial-thickness burns on the entire anterior trunk and the anterior right arm. Using the Rule of Nines, what is the total percentage of body surface area burned? 

A client with severe burns presents with signs of hypovolemic shock. What is the most important initial assessment the nurse should perform? 

A 68-year-old client with a history of congestive heart failure presents to the emergency department with acute pulmonary edema. The nurse performs an initial assessment and notes the following: respiratory rate 32 breaths/min, bilateral crackles on auscultation, oxygen saturation of 85% on room air, and extreme anxiety. Which of the following interventions should the nurse prioritize to manage this client’s condition? Select all that apply and provide rationale for your choices.

A client is admitted with a pneumothorax and has a chest tube inserted. Which intervention should the nurse perform to ensure the chest tube is functioning properly? 

INSTRUCTIONS:  Calculate the following dosage problems and show your work on the test.  You may use your calculator.  Clearly fill-in only one answer for each question.  Fill in the blank with your answer.   INSTRUCTIONS FOR ROUNDING OFF NUMBERS:  1) Round off gtts / min to the nearest whole number.  EXAMPLES:  16.7 gtts / min = 17 gtts / min  OR  14.2 gtts / min = 14 gtts / min  2) Round off answers LESS than 1 to 2 decimal points (hundredths).  EXAMPLES:  0.035 = 0.04  OR  0.201 = 0.20  3) Round off answers GREATER than 1 to 1 decimal point (tenths).  EXAMPLES:  1.65 = 1.7  OR  1.23 = 1.2  4) Round off mL / hr to the nearest whole number.  EXAMPLES:  1.4 mL / hr = 1 mL / hr   OR   1.6 mL / hr = 2 mL / hr  5) Round off weights in Kg to one decimal point (tenths).  EXAMPLES:  30.46 Kg = 30.5 Kg  OR  22.32 Kg = 22.3 Kg  ________________________________________________________________       A client is prescribed 1G potassium phosphate IV to be infused continuously over 6 hours.  Available is 1G potassium phosphate in 500mL dextrose 5% water (D5W). The nurse should set the IV pump to run at how many mL/Hr? mL/Hr   

A client with sepsis has an ABG that shows: pH: 7.30, PaCO2: 45, HCO3 18. Which acid base imbalance does the client have? 

Which of the following correctly lists the major steps involved in human sexual differentiation in the typical order they occur? A) Genital formation → Chromosomal sex → Puberty → Gonad formation → Internal duct formationB) Chromosomal sex → Gonad formation → Internal duct formation → Genital formation → PubertyC) Chromosomal sex → Internal duct formation → Genital formation → Puberty → Gonad formationD) Gonad formation → Chromosomal sex → Puberty → Internal duct formation → Genital formation

  Which of the following best describes an intersex individual? A) A person whose reproductive anatomy is completely male or femaleB) A person who identifies as both male and femaleC) A person with genetic, hormonal, or anatomical traits that do not fit typical binary definitions of male or femaleD) A transgender person undergoing hormone replacement therapy