Nokea
A client is being taught about patient-controlled analgesia (PCA). Which statement should be included in the teaching?
- A. The PCA will deliver a double dose of medication when you push the button twice.
- B. Continuous PCA infusion is designed to allow fluctuating plasma medication levels.
- C. You should push the button before physical activity to allow maximum pain control.
- D. You can adjust the amount of pain medication you receive by pushing on the keypad.
Correct Answer: D
Rationale: The correct statement to include in the teaching about PCA is that the client can adjust the amount of pain medication they receive by pushing on the keypad. This empowers the client to control their pain management effectively. Choice A is incorrect because PCA systems are programmed to prevent double dosing when the button is pressed multiple times in quick succession. Choice B is incorrect as continuous PCA infusion aims to maintain a steady plasma medication level. Choice C is incorrect because it is not necessary to push the button before physical activity to ensure maximum pain control; the client should use the PCA as needed for pain relief.
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A nurse is providing teaching to a client who has diabetes mellitus and a new prescription for insulin glargine. Which of the following instructions should the nurse include?
- A. You should inject this medication once a day, at the same time each day.
- B. You should expect your blood glucose level to increase immediately after administration.
- C. You should rotate injection sites between your abdomen and thigh.
- D. You should inject this medication with your meals.
Correct Answer: A
Rationale: The correct instruction that the nurse should include is to inject insulin glargine once a day, at the same time each day. Insulin glargine is a long-acting insulin that provides a consistent level of insulin over 24 hours, helping to maintain stable blood glucose levels. Option B is incorrect because insulin glargine does not cause an immediate increase in blood glucose levels. Option C is important for preventing lipodystrophy but is not specific to insulin glargine administration. Option D is incorrect because insulin glargine is typically administered at the same time each day, regardless of meals.
A nurse is providing teaching to a client who is receiving radiation therapy for cancer of the larynx. Which of the following instructions should the nurse include?
- A. Apply heat to the neck to relieve pain.
- B. Use a soft-bristle toothbrush to prevent gum irritation.
- C. Rinse your mouth with an alcohol-free mouthwash twice daily.
- D. Wear loose-fitting clothing to protect your skin.
Correct Answer: B
Rationale: The correct answer is to use a soft-bristle toothbrush to prevent gum irritation in clients undergoing radiation therapy for laryngeal cancer. Radiation therapy can cause oral mucositis and increase the risk of gum irritation, so using a soft-bristle toothbrush is recommended to minimize trauma to the gums and oral mucosa. Applying heat to the neck is contraindicated as it can exacerbate tissue damage caused by radiation. Rinsing the mouth with an alcohol-free mouthwash is preferred over an alcohol-based one to prevent drying and irritation of the oral mucosa. Wearing loose-fitting clothing is advised to prevent friction and irritation on the skin, rather than tight-fitting clothing that may cause pressure ulcers or skin breakdown.
A nurse is preparing to administer an intermittent enteral feeding to a client who has a nasogastric tube. Which of the following actions should the nurse take?
- A. Check for residual feeding contents.
- B. Administer the feeding through a large-bore syringe.
- C. Flush the tube with 10 mL of water after feeding.
- D. Administer the feeding at room temperature.
Correct Answer: C
Rationale: The correct action for the nurse to take when preparing to administer an intermittent enteral feeding through a nasogastric tube is to flush the tube with 10 mL of water after feeding. This helps maintain tube patency and prevent clogging. Choice A, checking for residual feeding contents, is not the immediate action to take before administering the feeding. Choice B, administering the feeding through a large-bore syringe, is not the recommended method for administering enteral feedings. Choice D, administering the feeding at room temperature, is important but not the immediate action related to tube maintenance.
A nurse is assessing a client who is 1 day postoperative following hip replacement surgery. Which of the following findings should the nurse report to the provider?
- A. Heart rate of 88/min
- B. Serosanguineous drainage on the surgical dressing
- C. Blood pressure of 118/76 mm Hg
- D. Urine output of 40 mL/hr
Correct Answer: D
Rationale: The correct answer is D: Urine output of 40 mL/hr. A low urine output may indicate kidney complications, such as acute kidney injury, which is a critical finding postoperatively. The nurse should report this immediately to the provider for further evaluation and management. Choices A, B, and C are within normal limits for a client who is 1 day postoperative following hip replacement surgery and do not indicate immediate concerns that require reporting to the provider.
A healthcare provider is preparing education material for a client. Which technique should the healthcare provider use in creating the material?
- A. Emphasize important information using bold lettering.
- B. Use a 7th-grade reading level.
- C. Avoid using cartoons in the material.
- D. Use words with three or four syllables.
Correct Answer: B
Rationale: Using a 7th-grade reading level is the most effective technique when creating education material for clients because it ensures that the content is easily understood by a wide range of individuals. Option A, emphasizing important information with bold lettering, may help draw attention but doesn't guarantee comprehension. Option C, avoiding cartoons, is not necessarily a universal rule and can sometimes make material more engaging. Option D, using words with three or four syllables, can make the material more complex and harder to understand, defeating the purpose of effective communication in education material.