Nokea
A client asks a nurse working in a dental office what type of drug the dentist uses to provide anesthesia during the extraction of the client's wisdom teeth. The dentist uses an anesthetic gas, also known as laughing gas. This agent is:
- A. nitrous oxide.
- B. nitrogen.
- C. nitric oxide.
- D. nitrogen dioxide.
Correct Answer: A
Rationale: Nitrous oxide produces analgesia and is often used for minor surgery and dental procedures that do not require loss of consciousness. It can also produce a mild euphoria in some clients.
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The nurse is initiating an IV infusion of lactated Ringer's (LR) for the client in shock. What is the purpose of LR for this client?
- A. Increase fluid volume and urinary output
- B. Draw water from the cells into the blood vessels
- C. Provide dextrose and nutrients to prevent cellular death
- D. Replace potassium and magnesium for cardiac stabilization
Correct Answer: A
Rationale: A: LR is an isotonic crystalloid solution containing multiple electrolytes in approximately the same concentration as plasma. It enters the cells from the blood, provides fluids, and increases urinary output. B: A hypertonic solution draws fluid from the cells into the vascular compartment; LR is isotonic. C: LR alone does not contain dextrose. Formulations with dextrose are available. D: Magnesium is not a component of LR.
The nurse is assessing the client who has begun therapy with duloxetine. Which assessment parameter should be the nurse's priority?
- A. Relief of neuropathic pain
- B. Increase in anxiety or irritability
- C. Liver function test (LFT) results
- D. Experiencing suicidal ideations
Correct Answer: D
Rationale: Duloxetine (Cymbalta) is a serotonin norepinephrine reuptake inhibitor (SSNRI) used in the treatment of major depression. Suicidal ideation is the most acute threat to life and should be assessed, especially when initiating duloxetine.
A 20-year-old obese female client is preparing to have gastric bypass surgery for weight loss. She says to the nurse, 'I need this surgery because nothing else I have done has helped me to lose weight.' Which response by the nurse is most appropriate?
- A. If you eat less, you can save some money.'
- B. Exercise is a healthier way to lose weight.'
- C. You should try the Atkins diet first.'
- D. I respect your decision to choose surgery.'
Correct Answer: D
Rationale: This statement is most appropriate, as it shows respect and empathy. The other statements are both insensitive and unprofessional.
A physician orders a serum creatinine for a hospitalized client. The nurse should explain to the client and his family that this test:
- A. is normal if the level is 4.0 to 5.5 mg/dl.
- B. can be elevated with increased protein intake.
- C. is a better indicator of renal function than the BUN.
- D. reflects the fluid volume status of a person.
Correct Answer: C
Rationale: A serum creatinine level should be 0.7 to 1.5 mg/dl, and it does not vary with increased protein intake, so it is a better indicator of renal function than the BUN, which can be affected by diet and hydration status.
An allergic reaction is classified as what type of pharmacological effect?
- A. a therapeutic effect
- B. a side effect
- C. an adverse effect
- D. an incompatibility
Correct Answer: C
Rationale: An allergic reaction is considered an adverse effect, as it is unintended and requires treatment. A side effect is also undesired but is somewhat expected, and a side effect does not require intervention.