Nokea
A client who has a history of long-standing back pain treated with methadone (Dolophines), is admitted to the surgical unit following urological surgery. Which modifications in the plan of care should the nurse make for this client's pain management during the postoperative period?
- A. Consult with surgeon about increasing methadone in lieu of parenteral opioids.
- B. Use minimal parenteral opioids for surgical pain, in addition to oral methadone
- C. Maintain client's methadone, and medicate surgical pain based on pain rating
- D. Make no changes in the standard pain management for the surgery and hold methadone.
Correct Answer: C
Rationale: Maintaining the client's methadone regimen while addressing surgical pain ensures effective pain control without risking withdrawal or inadequate pain relief.
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Pulsus paradoxus is associated with
- A. pericarditis
- B. endocarditis
- C. rheumatic fever
- D. myocarditis
Correct Answer: A
Rationale: Pulsus paradoxus is commonly associated with pericardial diseases such as constrictive pericarditis.
Renin:
- A. Is secreted mainly in extrarenal tissues
- B. Secretion increases on lying supine
- C. Secretion increases with potassium
- D. Converts angiotensin I into angiotensin II
Correct Answer: D
Rationale: Renin is an enzyme produced by the kidneys that converts angiotensin I into angiotensin II which plays a key role in regulating blood pressure and fluid balance. The other options are incorrect because renin is not mainly secreted in extrarenal tissues its secretion does not increase on lying supine or with potassium and it does not regulate osmolality.
The nurse reviews the laboratory results for a child with a suspected diagnosis of rheumatic fever. The nurse knows that which laboratory study would assist in confirming the diagnosis?
- A. Immunoglobulin
- B. Red blood cell count
- C. White blood cell count
- D. Anti-streptolysin O titer
Correct Answer: D
Rationale: The Anti-streptolysin O titer is used to confirm a diagnosis of rheumatic fever as it indicates a recent streptococcal infection, which is a precursor to rheumatic fever.
Regarding the genetics of CF:
- A. The commonest mutation in Caucasians is the ~F-580
- B. The affected protein is a transmembrane Na channel
- C. Accurate prenatal diagnosis is possible in all cases
- D. There are less than 10 mutations causing disease
Correct Answer: B
Rationale: the affected protein in cystic fibrosis (CF) is the cystic fibrosis transmembrane conductance regulator (CFTR), which is a chloride channel, not a sodium channel. The other options are incorrect: (a) The commonest mutation in Caucasians is ΔF508, not ~F-580. (b) Parents of an affected child are typically carriers and do not show symptoms. (c) Prenatal diagnosis is not possible in all cases due to the vast number of mutations. (d) There are over 2000 known mutations causing CF.
A client with pheochromocytoma reports the onset of a severe headache. The nurse observes that the client is very diaphoretic. Which assessment data should the nurse obtain next?
- A. Blood pressure
- B. Blood glucose level
- C. Respiratory rate
- D. Oxygen saturation
Correct Answer: A
Rationale: Pheochromocytoma can lead to hypertension, which may be responsible for the client’s symptoms. Monitoring blood pressure is crucial to assess for potential hypertensive crisis.