Nokea
A child returns from exploratory surgery following a gunshot wound to the abdomen. Which nursing intervention should be excluded from the plan of care?
- A. Immediate initiation of oral feedings
- B. Assessment of the surgical site
- C. Administration of opioid narcotics for pain management
- D. Visitation at the bedside
Correct Answer: A
Rationale: Immediate initiation of oral feedings is contraindicated post-abdominal surgery due to the risk of bowel complications such as paralytic ileus or anastomotic leak. Starting oral feedings immediately can increase the risk of these complications and hinder the healing process. It is crucial to wait until bowel function returns and the patient shows signs of tolerance before introducing oral feedings. Assessment of the surgical site, administration of opioid narcotics for pain management, and visitation at the bedside are essential components of postoperative care and should not be excluded.
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Small round blue cell tumors refer to all the following EXCEPT
- A. non-Hodgkin lymphoma
- B. osteosarcoma
- C. Ewing sarcoma
- D. rhabdomyosarcoma
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
Which of the following is not a model centered on occupation?
- A. Canadian Model of Occupational Performance and Engagement
- B. Person-Environment-Occupation-Participation
- C. Biomechanical
- D. Model of Human Occupation
Correct Answer: C
Rationale: The biomechanical model focuses on the physical aspects of performance rather than occupation, making it the correct answer. The Canadian Model of Occupational Performance and Engagement, Person-Environment-Occupation-Participation, and Model of Human Occupation are all occupation-centered models used in occupational therapy.
In the morning, a healthcare professional receives change-of-shift report on four pediatric clients, each of whom has some form of fluid-volume excess. Which of the children should the healthcare professional see first?
- A. The child with tachypnea and pulmonary congestion
- B. The child with hepatomegaly and normal respiratory rate
- C. The child with dependent and sacral edema and regular pulse
- D. The child with periorbital edema and normal respiratory rate
Correct Answer: A
Rationale: The child with tachypnea and pulmonary congestion should be seen first as these symptoms indicate a more severe form of fluid-volume excess that requires immediate attention. Tachypnea is an increase in respiratory rate, which could be a sign of respiratory distress, and pulmonary congestion indicates fluid accumulation in the lungs, posing a significant risk to the child's respiratory function.
A 5-year-old girl requires a craniotomy for subarachnoid hemorrhage following a motor vehicle collision. Which of the following parameters is consistent with a postoperative diagnosis of syndrome of inappropriate antidiuretic hormone secretion (SIADH)?
- A. Serum osmolality 300 mOsm/L
- B. Serum sodium 128 mEq/L
- C. Urine sodium < 20 mmol/L
- D. N/A
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
What is the most appropriate nursing consideration for a patient who is prescribed verapamil and digoxin?
- A. Restrict intake of oral fluids and high-fiber foods
- B. Take an apical pulse for 30 seconds before administration
- C. Notify the healthcare provider of nausea, vomiting, and visual changes
- D. Hold the medications if the heart rate is greater than 110 bpm
Correct Answer: C
Rationale: When a patient is prescribed verapamil and digoxin, it is crucial to monitor for signs of digoxin toxicity due to the potential interaction between these medications. Verapamil can elevate digoxin blood serum levels, increasing the risk of toxicity. Symptoms of digoxin toxicity include nausea, vomiting, and visual changes. Restricting intake of oral fluids and high-fiber foods is not a specific consideration related to this medication combination. Before administering digoxin, it is essential to take an apical pulse for a full minute, not just 30 seconds. Additionally, holding the medications if the heart rate exceeds 110 bpm is not a typical response to the combination of verapamil and digoxin, which can cause bradycardia rather than tachycardia.