Nokea
A client is scheduled to have an elective mandibular osteotomy to correct a mandibular fracture sustained in an accident 6 months earlier. Which statement by the client indicates to the nurse maladaptive coping?
- A. œI will be glad to have my jaw fixed because my wife thinks I do not look like myself.'
- B. œI am somewhat afraid to have the surgery but feel OK about it.'
- C. œMy wife will help me, but I don't think I will need that much help.'
- D. œI am ready to get this over with.'
Correct Answer: A
Rationale: The statement about the wife's perception suggests the client's motivation is external and may reflect poor self-image or reliance on others' opinions, indicating maladaptive coping. The other statements show acceptance, realistic fear, or confidence, which are more adaptive.
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A client uses timolol maleate (Timoptic) eyedrops. The expected outcome of this beta-adrenergic blocker is to control glaucoma by:
- A. Constricting the pupils.
- B. Dilating the canals of Schlemm.
- C. Reducing aqueous humor formation.
- D. Improving the ability of the ciliary muscle to contract.
Correct Answer: C
Rationale: Timolol maleate, a beta-adrenergic blocker, reduces intraocular pressure by decreasing the production of aqueous humor in the eye.
After treatment with radioactive iodine (RAI) in the form of sodium iodide 131I, the nurse teaches the client to:
- A. Monitor for signs and symptoms of hyperthyroidism.
- B. Rest for 1 week to prevent complications of the medication.
- C. Take thyroxine replacement for the remainder of the client's life.
- D. Assess for hypertension and tachycardia resulting from altered thyroid activity.
Correct Answer: C
Rationale: RAI often destroys enough thyroid tissue to cause hypothyroidism, requiring lifelong thyroxine replacement. Monitoring for hyperthyroidism is unnecessary post-treatment, and rest or assessing for hypertension/tachycardia are not primary concerns.
The nurse in the intensive care unit is giving a report to the nurse in the post-surgical unit about a client who had a gastrectomy. The most effective way to assure essential information about the client is reported is to:
- A. Give the report face-to-face with both nurses in a quiet room.
- B. Audiotape the report for future reference and documentation.
- C. Use a printed checklist with information individualized for the client.
- D. Document essential transfer information in the client's electronic health record.
Correct Answer: C
Rationale: A printed checklist individualized for the client ensures all essential information is communicated consistently and reduces the risk of omissions during the report.
The nurse has attended a continuing education conference regarding medication administration and meal times. Which statement, if made by the nurse, would indicate correct understanding?
- A. Proton pump inhibitors (PPls) should be given as the client eats their breakfast.
- B. Glucocorticoids should be given on an empty stomach to prevent gastrointestinal irritation.
- C. Rapid-acting insulins should be administered approximately 5-10 minutes before meals
- D. Levodopa-Carbidopa should be administered with a high-protein snack to enhance its absorption.
Correct Answer: C
Rationale: Rapid-acting insulins are administered 5-10 minutes before meals to match glucose spikes.
A client is admitted to the emergency department with a full thickness burn to his right arm. Upon assessment, the arm is edema, the agent is mottled, and radial pulse is now absent. The client states that the pain is 8 on a scale of 1 to 10 . The nurse should:
- A. Administer morphine sulfate I.V. push for the severe pain.
- B. Call the physician to report the loss of the radial pulse.
- C. Continue to assess the arm every hour for any additional changes.
- D. Instruct the client to exercise his fingers and wrist.
Correct Answer: B
Rationale: The absence of the radial pulse indicates potential compartment syndrome or vascular compromise, which is a medical emergency requiring immediate physician notification to prevent tissue necrosis.