Nokea
A 48-year-old patient has been prescribed trihexyphenidyl for her Parkinson's disease. Which adverse reaction to this drug can be close-related?
- A. Excessive salivation
- B. Bradycardia
- C. Dryness of mouth
- D. Constipation
Correct Answer: C
Rationale: Trihexyphenidyl is an anticholinergic medication commonly used to treat symptoms of Parkinson's disease. Anticholinergic drugs work by blocking the action of acetylcholine, a neurotransmitter in the nervous system. One common side effect of anticholinergic medications like trihexyphenidyl is dryness of the mouth (xerostomia). This occurs because the drug interferes with the normal functioning of the salivary glands, leading to reduced saliva production. Excessive salivation (choice A) is unlikely due to the drying effect of the medication. Bradycardia (choice B) is not typically associated with trihexyphenidyl use. Constipation (choice D) is another common adverse effect of anticholinergic medications, but dryness of the mouth is more closely related in this scenario.
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Patients are at risk for overwhelming postsplenectomy infection (OPSI) following splenectomy. Which of the ff. symptoms alerts the nurse to this possibility?
- A. Bruising around the operative site
- B. Pain
- C. Irritability
- D. Fever
Correct Answer: D
Rationale: Patients who have undergone splenectomy are at risk for overwhelming postsplenectomy infection (OPSI) due to the absence of a functioning spleen, which is important in fighting certain types of infections, especially those caused by encapsulated bacteria such as Streptococcus pneumoniae. Symptoms of OPSI can include fever, chills, weakness, and rapid breathing. Fever is a significant sign that alerts the nurse to the possibility of OPSI in a post-splenectomy patient, as it may indicate an infection that the body is struggling to fight without the spleen's immune support. This is a crucial symptom to monitor and act upon promptly to prevent serious complications in these individuals.
A client with a history of cardiac dysrhythmias is admitted to the hospital with the diagnosis of dehydration. The nurse should anticipate that the physician will order;
- A. A glass of water every hour until hydrated
- B. Small frequent intake of juices, broth, or milk
- C. Short-term NG replacement of fluids and nutrients
- D. A rapid IV infusion of an electrolyte and glucose solution
Correct Answer: D
Rationale: A client with a history of cardiac dysrhythmias and dehydration requires careful monitoring and management of fluid and electrolyte balance. The most appropriate intervention for rapid correction of dehydration in this scenario is a rapid IV infusion of an electrolyte and glucose solution. This method allows for the quick replacement of fluids and essential electrolytes to restore the client's hydration status efficiently and effectively. Administering fluids orally may not be adequate in this situation, and NG replacement of fluids and nutrients may not be necessary if the client's condition can be managed through IV therapy. Therefore, option D is the most appropriate choice for this client.
Sexual abuse should be considered in children who have behavioral problems, although no behavior is pathognomonic. Which of the following behavior should raise the suspicion of sexual abuse?
- A. aggressive
- B. obsessive-compulsive
- C. dissociative
- D. hypersexuality
Correct Answer: D
Rationale: Hypersexuality in children is highly unusual and strongly indicative of possible sexual abuse, as it reflects exposure to inappropriate sexual content or experiences.
On a visit to the gynecologist, a client complains of urinary frequency, pelvic discomfort, and weight loss. After a complete physical examination, blood studies, and a pelvic examination with a Papanicolaou test, the physician diagnoses stage IV ovarian cancer. The nurse expects to prepare the client for which initial treatment?
- A. Radiation therapy
- B. Chemotherapy
- C. Major surgery
- D. None
Correct Answer: C
Rationale: In the case of stage IV ovarian cancer, initial treatment typically involves major surgery, known as cytoreductive surgery or debulking surgery. The goal of this surgery is to remove as much of the tumor burden as possible from the abdomen and pelvis. By reducing the size of the tumor, the effectiveness of subsequent treatments such as chemotherapy can be enhanced. Surgery may also involve the removal of the uterus, ovaries, fallopian tubes, and surrounding tissue. Radiation therapy or chemotherapy may be used after surgery to further target any remaining cancer cells. However, major surgery is often the first step in the management of advanced ovarian cancer.
Which of the ff is an initial sign or symptom of acute bronchitis?
- A. Nonproductive cough
- B. Anorexia
- C. Labored breathing
- D. Gastric ulceration
Correct Answer: A
Rationale: An initial sign or symptom of acute bronchitis is a nonproductive cough. This type of cough produces little to no phlegm or sputum. As the condition progresses, the cough may become productive, with the production of thick yellow or green mucus. Other common symptoms of acute bronchitis may include chest discomfort, fatigue, mild fever, and sore throat. Labored breathing is more commonly associated with conditions such as pneumonia or asthma, while anorexia and gastric ulceration are not typically initial signs of acute bronchitis.