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Reduction of Risk Potential Flashcards

7 cards from real NACE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Reduction of Risk Potential flashcards as text
  1. A nurse reviews a client's medication list and notes they are taking warfarin. Which laboratory value is most critical to monitor to reduce risk of bleeding complications?

    Answer: International Normalized Ratio (INR)

    INR is the standard test used to monitor warfarin therapy and guide dosing to prevent hemorrhage.

  2. A postoperative client reports sudden onset of chest pain and shortness of breath on day 2 after hip replacement surgery. What is the nurse's priority action?

    Answer: Notify the physician immediately

    Sudden chest pain and dyspnea after orthopedic surgery are classic signs of pulmonary embolism, requiring immediate physician notification.

  3. Which nursing intervention best reduces the risk of aspiration in a client receiving continuous enteral tube feedings?

    Answer: Keep the head of bed elevated at 30–45 degrees

    Elevating the head of the bed 30–45 degrees reduces gastroesophageal reflux and the risk of aspiration pneumonia.

  4. A client with chronic kidney disease has a serum potassium of 6.2 mEq/L. Which assessment finding requires the nurse's most immediate action?

    Answer: Irregular cardiac rhythm on telemetry

    Hyperkalemia causes cardiac dysrhythmias, which can be life-threatening and require immediate intervention.

  5. A nurse is caring for a client receiving a blood transfusion who develops hives, itching, and mild urticaria 15 minutes after the infusion begins. What is the priority nursing action?

    Answer: Stop the transfusion, keep the IV open with normal saline, and notify the physician

    An allergic transfusion reaction requires stopping the transfusion, maintaining IV access with normal saline, and notifying the physician to determine further management.

  6. A nurse prepares to insert a urinary catheter. Which action is most important in reducing the risk of catheter-associated urinary tract infection (CAUTI)?

    Answer: Maintaining a closed drainage system

    Maintaining a sterile, closed drainage system is the single most effective measure for preventing CAUTI.

  7. A client who underwent general anesthesia 4 hours ago has a temperature of 39.2°C (102.6°F), tachycardia, and muscle rigidity. Which condition does the nurse suspect?

    Answer: Malignant hyperthermia

    Malignant hyperthermia is a life-threatening reaction to certain anesthetic agents characterized by hyperthermia, tachycardia, and severe muscle rigidity.