HESI Live Review Test Guide for the NCLEX-RN Exam % Upgraded

A client reports to the nurse he has not had a BM in 2 days. Which intervention should the nurse implement first? A. instruct caregiver to offer a glass of prune juice B. notify HCP and request script for stool softener C. Assess clients med rec and see normal BM pattern D. Instruct caregiver to increase clients fluids to five 8 ounce glasses per day. - C!! Always assess first. You dont know enough to ask for stool softener A client who has COPD is resting in semi fowlers w/ O2 BNC 2L. The client develops dyspnea. What action does the nurse take first? A. Call HCP B. Obtain bedside pulse ox C. Raise HOB D. Assess clients vital signs - C!! B and D are the same-- that is a flag A client who has hyperparathyroidism is scheduled to receive a prescribed dose of oral phosphate. The RN notes that the clients serum calcium level is 12.5mg/dL. What action should to nurse take? A. hold the phosphate and notify the HCP B. review clients serum PTH C. Give PRN IV Ca D. Admin oral dose of PO4 - D! Ca and PO4 have an inverse relationship In completing a clients pre-op routine, the RN finds that the consent has not been signed. The clients begins to ask more questions about the surgical procedure. What action should the nurse take next? A. Witness the client's signature on the consent B. Answer the clients questions about th