Nokea
A client is transferred to his room from the intensive care unit after a craniotomy for treatment of a malignant brain tumor in the occipital region. The nurse should question which of these orders?
- A. 400 mg of ibuprofen (Motrin).
- B. 500 mg of naproxen (Naprosyn).
- C. Morphine sulfate.
- D. Acetaminophen (Tylenol).
Correct Answer: A
Rationale: Ibuprofen (an NSAID) should be questioned post-craniotomy due to the risk of bleeding, which can be exacerbated by its antiplatelet effects in the context of recent brain surgery.
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A client with cancer develops superior vena cava syndrome (SVCS). Which of the following symptoms should the nurse assess for?
- A. Facial swelling and dyspnea.
- B. Lower extremity edema.
- C. Abdominal distension.
- D. Flank pain.
Correct Answer: A
Rationale: SVCS obstructs venous return, causing facial swelling and dyspnea due to compression of the superior vena cava, which the nurse should prioritize in assessment.
A client with cancer has diarrhea and a nursing diagnosis of Impaired skin integrity related to the frequent diarrhea. Which of the following nursing interventions is appropriate for this diagnosis?
- A. Discourage sitz baths because they promote bacterial growth.
- B. Apply zinc oxide ointment to the rectal area after each bowel movement to protect the skin.
- C. Apply a skin-barrier dressing daily to the rectal area to form a protective barrier.
- D. Clean the rectal area with unscented soap and water after each bowel movement, rinse well, and pat dry.
Correct Answer: D
Rationale: Cleaning with unscented soap and water, rinsing, and patting dry after each bowel movement prevents skin breakdown and maintains integrity in clients with diarrhea.
A client with acute renal failure has an increase in the serum potassium level. The nurse should monitor the client for:
- A. Cardiac arrest.
- B. Pulmonary edema.
- C. Circulatory collapse.
- D. Hemorrhage.
Correct Answer: A
Rationale: Elevated potassium can cause cardiac arrhythmias, potentially leading to cardiac arrest, requiring close monitoring.
A client who is recovering from gastric surgery is receiving I.V. fluids to be infused at 100 mL/hour. The I.V. tubing delivers 15 gtt/mL. The nurse should infuse the solution at a flow rate of how many drops per minute to ensure that the client receives 100 mL/hour?
Correct Answer: 25 gtt/minute
Rationale: To calculate: (100 mL/hour × 15 gtt/mL) ÷ 60 minutes/hour = 25 gtt/minute. The nurse should set the flow rate to 25 drops per minute.
Which of the following systems is not blocked by spinal anesthesia?
- A. The sympathetic nervous system.
- B. The sensory system.
- C. The parasympathetic nervous system.
- D. The motor system.
Correct Answer: C
Rationale: Spinal anesthesia blocks sensory, motor, and sympathetic systems by affecting nerve roots. The parasympathetic system, mediated by cranial and sacral nerves, is not typically blocked.