Nokea
A client undergoing a bilateral adrenalectomy has postoperative orders for hydromorphone hydrochloride (Dilaudid) 2 mg to be given subcutaneously every 4 hours as needed for pain. The medication is administered in relatively small doses primarily because it is:
- A. Less likely to cause dependency in small doses.
- B. Less irritating to subcutaneous tissues in small doses.
- C. As potent as most other analgesics in larger doses.
- D. Excreted before accumulating in toxic amounts in the body.
Correct Answer: C
Rationale: Hydromorphone is a potent opioid, effective in small doses, reducing the need for larger doses that increase side effect risks.
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The nurse should instruct the client to eat which of the following foods to obtain the best supply of vitamin B12?
- A. Whole grains.
- B. Green leafy vegetables.
- C. Meats and dairy products.
- D. Broccoli and brussels sprouts.
Correct Answer: C
Rationale: Vitamin B12 is primarily found in animal products, such as meats and dairy products, making them the best dietary sources. Whole grains, green leafy vegetables, broccoli, and brussels sprouts contain little to no vitamin B12. Clients with B12 deficiency, such as those with pernicious anemia, should be encouraged to consume meats and dairy to meet their B12 needs.
What should the nurse teach a client about how to avoid the dumping syndrome? Select all that apply.
- A. Consume three regularly-spaced meals per day.
- B. Eat a diet with high carbohydrate foods with each meal.
- C. Reduce fluids with meals, but take them between meals.
- D. Obtain adequate amounts of protein and fat in each meal.
- E. Eat in a relaxing environment.
Correct Answer: C,D,E
Rationale: To avoid dumping syndrome, clients should reduce fluids with meals, ensure adequate protein and fat, and eat in a relaxing environment. Three meals a day and high-carbohydrate foods can exacerbate symptoms.
When administering I.V. midazolam hydrochloride (Versed) the nurse should?
- A. Assess the blood pressure.
- B. Monitor the pulse oximeter.
- C. Encourage slow, deep breaths.
- D. Explain relaxation techniques.
Correct Answer: B
Rationale: Midazolam can cause respiratory depression, so monitoring the pulse oximeter is essential to ensure adequate oxygenation during administration.
A client post-cystectomy is at risk for:
- A. Vitamin B12 deficiency.
- B. Hyperkalemia.
- C. Hypoglycemia.
- D. Dehydration.
Correct Answer: A
Rationale: Cystectomy may impair vitamin B12 absorption due to ileum resection.
A nurse is teaching a client about cystoscopy preparation. What instruction should be included?
- A. Fast for 8 hours before the procedure.
- B. Drink plenty of water before the test.
- C. Expect to stay overnight in the hospital.
- D. Empty the bladder before the procedure.
Correct Answer: D
Rationale: Emptying the bladder ensures a clear view during cystoscopy and reduces discomfort.