Nokea
Mr. Santos a 59-year old businessman was diagnosed with angina pectoris. The nurse understands that the cause of angina pectoris is:
- A. decrease in the alveolar surface for gas exchange
- B. inadequate supply of oxygen to the myocardium
- C. inadequate blood pressure in the pulmonary circulation
- D. increase in the alveolar surface for gas exchange
Correct Answer: B
Rationale: Angina pectoris is chest pain or discomfort caused by a temporary lack of an adequate blood supply to the heart muscle (myocardium). This lack of blood supply results in a decreased supply of oxygen to the heart muscle, leading to chest pain. This condition is commonly associated with coronary artery disease, where the arteries that supply blood to the heart become narrowed or blocked, reducing the flow of oxygen-rich blood to the myocardium. This oxygen deficit can trigger chest pain, which is characteristic of angina pectoris. Therefore, the cause of angina pectoris is the inadequate supply of oxygen to the myocardium, making option B the correct answer.
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Nurse Raymond is giving instructions to an elderly client on diabetic foot care. Which teaching is not part of foot care?
- A. wear comfortable shoes that fit well and protect your feet
- B. trim your toenails straight across and file edges with emery board
- C. wash your feet in hot water to keep feet soft
- D. wear shoes at the beach or on hot pavement
Correct Answer: C
Rationale: Washing your feet in hot water is not recommended for diabetic foot care as it can increase the risk of burns and skin damage due to reduced sensitivity and circulation in the feet. Instead, it is advised to wash your feet in warm water, not hot, and to thoroughly dry them, especially in between the toes, to prevent fungal infections.
When the patient's signature is witnessed by the nurse on the surgical consent, which of the following does the nurse's signature indicate?
- A. The nurse obtained informed consent.
- B. The nurse provided informed consent.
- C. The nurse answered all surgical procedure questions.
- D. The nurse verified that the patient signed the consent.
Correct Answer: D
Rationale: The nurse's signature on the surgical consent form indicates that the nurse has verified and confirmed that the patient has signed the consent form. This step is crucial to ensure that the patient has voluntarily given their consent for the surgical procedure. It does not mean that the nurse obtained or provided informed consent, answered all surgical procedure questions, or made decisions on behalf of the patient. The nurse's role is to act as a witness to the patient's signature on the consent form to acknowledge that the patient has agreed to the procedure and signed the document.
When evaluating a severely depressed adolescent, the nurse knows that one indicator of a high risk for suicide is:
- A. Depression
- B. Excessive sleepiness
- C. A history of cocaine use
- D. A preoccupation with death
Correct Answer: D
Rationale: A key indicator of high risk for suicide in a severely depressed adolescent is a preoccupation with death. This preoccupation may manifest as talking about death frequently, expressing a desire to die, or showing an interest in activities or media related to death. It is important for healthcare providers to take any mention of suicidal thoughts or intentions seriously and to assess for other risk factors. While depression, excessive sleepiness, and a history of cocaine use may also be concerning in an adolescent's mental health assessment, a preoccupation with death is a more direct indicator of suicidal risk. It is crucial for healthcare providers to address suicidal ideation promptly and to ensure the adolescent receives appropriate mental health support and interventions.
Which may be given to high-risk children after exposure to chickenpox to prevent varicella?
- A. Acyclovir (Zovirax)
- B. Varicella globulin
- C. Diphenhydramine hydrochloride (Benadryl)
- D. VCZ immune globulin (VariZIG)
Correct Answer: D
Rationale: VCZ immune globulin (VariZIG) is given to high-risk children after exposure to chickenpox to prevent varicella. VariZIG contains antibodies against the varicella-zoster virus, providing passive immunity to the child. This can help reduce the severity of the infection or prevent it altogether in high-risk individuals. Acyclovir (Zovirax) is an antiviral medication used to treat varicella infections but is not typically used for prevention post-exposure. Varicella globulin is not a treatment for varicella. Diphenhydramine hydrochloride (Benadryl) is an antihistamine and is not used for preventing varicella post-exposure.
A client in the terminal stage of cancer is receiving continuous infusion of morphine (Duramorph) for pain management. Which assessment finding suggests that the client is experiencing an adverse effect of this drug?
- A. Voiding of 350mL of concentrated urine in
- B. Irregular heart rate of 82 beats/min
- C. Pupils constricted and equal
- D. Respiratory rate of 8breaths/min
Correct Answer: D
Rationale: The assessment finding that suggests the client is experiencing an adverse effect of morphine (Duramorph) is a respiratory rate of 8 breaths/min. Morphine is a potent opioid analgesic that can cause respiratory depression as a side effect. When the respiratory rate decreases significantly, it indicates the potential for compromised breathing, which could progress to respiratory failure. This is a serious adverse effect that requires immediate attention and evaluation by healthcare providers. The client receiving continuous infusion of morphine should be closely monitored for signs of respiratory depression to prevent life-threatening consequences.