Children with Spina Bifida always have a cognitive impairment as well.

Case: Mr. L., 71, is on day 2 after an inferior STEMI treated with PCI. He suddenly becomes acutely dyspneic and anxious. Assessment: BP 82/50 HR 124 RR 34 SpO₂ 82% on non-rebreather Diffuse crackles New loud holosystolic murmur best heard at the apex radiating to the axilla Cool, clammy extremities Which action is the priority?

The client remains hypertensive with persistent crackles despite oxygen therapy. The provider states, “We need to reduce afterload to improve forward flow.” Which medication best addresses this physiologic goal?

The client remains hypertensive with persistent crackles despite oxygen therapy. The provider states, “We need to reduce afterload to improve forward flow.” Which medication best addresses this physiologic goal?

An adult with septic shock is emergently intubated in the ED. The nurse begins post-intubation assessment while mechanical ventilation is initiated. Shortly after intubation, the client’s SpO₂ improves from 86% to 95%. Which findings indicate the endotracheal tube (ETT) is correctly placed? (Select all that apply.)  

A 72-year-old with end-stage heart failure has a signed DNR and POLST specifying comfort-focused treatment only (no intubation, no ICU transfer). The patient is severely dyspneic, anxious, and gasping despite 4 L nasal cannula. Family members state, “Please do everything to keep him alive.” Which action is most appropriate?

Ms. L., 72, with a history of heart failure, presents with worsening dyspnea and decreased exercise tolerance over 4 days. She reports sleeping upright in a recliner. Assessment and results: RR 30/min SpO₂ 88% on room air BP 142/84 BNP 1,200 pg/mL Na⁺ 130 mEq/L Creatinine 1.6 mg/dL Chest x-ray: interstitial and alveolar edema Echocardiogram last month: LVEF 28% Which interpretation is most accurate?

A client with asthma reports worsening shortness of breath despite using a rescue inhaler twice in the past hour. Assessment findings include: Peak flow: 45% of personal best RR 30/min HR 118/min SpO₂ 90% on room air Speaking in short phrases Intercostal retractions present Which instruction is the priority?

A 22-year-old client with moderate persistent asthma presents with increased wheezing over the past 24 hours and reports waking twice last night with shortness of breath. Assessment findings include RR 26/min, mild intercostal retractions, SpO₂ 94% on room air, and ability to speak in full sentences. The client’s personal best peak flow is 500 L/min. Today’s peak flow reading is 300 L/min. Which action by the nurse is most appropriate?  

A patient with severe COPD is admitted for worsening shortness of breath and increasing somnolence. The patient is receiving noninvasive ventilation (BiPAP). An arterial blood gas reveals: pH: 7.28 PaCO₂: 68 mm Hg PaO₂: 84 mm Hg on 40% FiO₂ Which best describes the patient’s condition?