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When caring for a client with acute pancreatitis, what intervention is most appropriate?
- A. Encourage a high-protein diet.
- B. Administer pain medication as needed.
- C. Provide small, frequent meals.
- D. Increase oral fluid intake.
Correct Answer: B
Rationale: The correct answer is B: Administer pain medication as needed. In acute pancreatitis, pain management is crucial to provide comfort and improve outcomes. Pain medication helps alleviate the severe abdominal pain associated with pancreatitis. It is essential to treat pain promptly to prevent complications and improve the client's quality of life. Encouraging a high-protein diet (A) is not recommended as it may exacerbate pancreatitis symptoms. Providing small, frequent meals (C) may help reduce the workload on the pancreas, but pain management takes precedence. Increasing oral fluid intake (D) is important for hydration but does not address the primary concern of pain relief in acute pancreatitis.
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A patient is assessing a client who has just been admitted to the emergency department. The client is having difficulty breathing and is using accessory muscles. What action by the nurse is best?
- A. Administer oxygen at 2 liters per minute via nasal cannula.
- B. Assess the client's vital signs including oxygen saturation.
- C. Notify the Rapid Response Team immediately.
- D. Place the client in a high Fowler's position.
Correct Answer: D
Rationale: The correct answer is D: Place the client in a high Fowler's position. Placing the client in a high Fowler's position helps improve lung expansion and oxygenation by maximizing chest expansion. This position facilitates better breathing mechanics and can alleviate respiratory distress.
Choice A is incorrect because administering oxygen via nasal cannula should be done after positioning the client properly. Choice B is important but assessing vital signs alone may not provide immediate relief to the client's breathing difficulty. Choice C, notifying the Rapid Response Team, is not the best immediate action as positioning the client correctly should be the priority before seeking additional help.
A patient with a history of asthma is scheduled for an appendectomy. Because of her asthma, you would include as part of the preoperative teaching the need to perform postoperatively
- A. Coughing and deep breathing exercises.
- B. Leg exercises.
- C. Wound dressing changes.
- D. All of these.
Correct Answer: A
Rationale: Deep breathing exercises help prevent postoperative complications in asthmatic patients.
A client presents to the emergency department with an acute myocardial infarction (MI) at 1500 (3:00 PM). The facility has 24-hour catheterization laboratory capabilities. To meet The Joint Commission's Core Measures set, by what time should the client have a percutaneous coronary intervention performed?
- A. 1530 (3:30 PM)
- B. 1600 (4:00 PM)
- C. 1630 (4:30 PM)
- D. 1700 (5:00 PM)
Correct Answer: C
Rationale: The correct answer is C: 1630 (4:30 PM). The rationale is as follows:
1. The standard guideline for performing percutaneous coronary intervention (PCI) in acute MI is within 90 minutes of arrival at the hospital.
2. The client arrived at 1500 (3:00 PM), so adding 90 minutes to this time gives us 1630 (4:30 PM).
3. This timing aligns with The Joint Commission's Core Measures for timely PCI in acute MI cases.
4. Therefore, the correct time for the client to have PCI performed is 1630 (4:30 PM).
In summary, choices A, B, and D are incorrect because they do not align with the 90-minute guideline for performing PCI in acute MI cases, as mandated by The Joint Commission's Core Measures.
A client is 4 hours postoperative following abdominal surgery. The client's blood pressure has dropped from 120/80 mm Hg to 90/60 mm Hg. What action should the nurse take first?
- A. Administer an IV fluid bolus.
- B. Check the surgical site for bleeding.
- C. Place the client in a Trendelenburg position.
- D. Notify the healthcare provider.
Correct Answer: B
Rationale: The correct answer is B: Check the surgical site for bleeding. This is the first action the nurse should take as a sudden drop in blood pressure postoperatively could indicate internal bleeding, a common complication after abdominal surgery. By assessing the surgical site for bleeding, the nurse can identify and address the source of the hypotension promptly. Administering IV fluids (choice A) may be necessary but should come after determining the cause. Placing the client in Trendelenburg position (choice C) is not recommended as it can worsen venous return and increase intracranial pressure. Notifying the healthcare provider (choice D) should be done after the nurse has assessed the situation and taken immediate action.
What is the side effect caused by tyramine in foods when taking an MAOI inhibitor?
- A. Cardiac dysrrhythmias
- B. Thyroid storm
- C. Hypertensive crisis
- D. Rhabdomyolysis
Correct Answer: C
Rationale: Tyramine interacts with MAOIs to cause a dangerous rise in blood pressure, known as hypertensive crisis.