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A client on a mechanical ventilator begins to fight the ventilator. Which medication will be ordered for the client?
- A. Sublimaze (fentanyl)
- B. Pavulon (pancuronium bromide)
- C. Versed (midazolam)
- D. Atarax (hydroxyzine)
Correct Answer: B
Rationale: Pavulon, a neuromuscular blocker, is used to paralyze respiratory muscles in clients fighting the ventilator, ensuring effective ventilation.
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The nurse is caring for a client with suspected endometrial cancer. Which symptom is associated with endometrial cancer?
- A. Frothy vaginal discharge
- B. Thick, white vaginal discharge
- C. Purulent vaginal discharge
- D. Watery vaginal discharge
Correct Answer: D
Rationale: Endometrial cancer often presents with abnormal uterine bleeding, which may manifest as watery or blood-tinged vaginal discharge. Frothy, thick white, or purulent discharges are more indicative of infections or other gynecologic conditions.
Which statement by the client regarding sickle cell disease indicates a need for further teaching?
- A. I should avoid strenuous exercise.
- B. I can enjoy one glass of red wine per day.
- C. I will avoid cigarettes and all tobacco products.
- D. I should avoid traveling to places at high altitudes such as Denver.
Correct Answer: B
Rationale: Alcohol, including red wine, can cause dehydration and increase the risk of sickle cell crisis, so it should be avoided. Other statements are correct.
Which of the following is a metabolic, life-threatening adverse reaction to general anesthesia?
- A. hypothermia
- B. hyperthermia
- C. hypoglycemia
- D. hyperglycemia
Correct Answer: B
Rationale: Malignant hyperthermia is a life-threatening reaction to general anesthesia, characterized by rapid temperature increase due to muscle hypermetabolism.
A client with otosderosis is scheduled for a stapedectomy. Which finding suggests a complication involving the seventh cranial nerve?
- A. Diminished hearing
- B. Sensation of fullness in the ear
- C. Inability to move the tongue side to side
- D. Changes in facial sensation
Correct Answer: D
Rationale: The seventh cranial (facial) nerve controls facial movements and sensation; changes in facial sensation post-stapedectomy suggest nerve involvement.
The nurse caring for a client with a suspected peptic ulcer recognizes which exam as the one most reliable in diagnosing the disease?
- A. Upper-gastrointestinal x-ray
- B. Gastric analysis
- C. Endoscopy
- D. Barium studies
Correct Answer: C
Rationale: Endoscopy directly visualizes the gastric mucosa, allowing for biopsy and definitive diagnosis of a peptic ulcer, making it the most reliable method.