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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The nurse is caring for a child after heart surgery. What should the nurse do if evidence of cardiac tamponade is found?
- A. Increase analgesia
- B. Apply warming blankets
- C. Immediately report this to physician
- D. Encourage child to cough, turn, and breathe deeply
Correct Answer: C
Rationale: If evidence is noted of cardiac tamponade, which is blood or fluid in the pericardial space constricting the heart, the physician is notified immediately of this life-threatening complication. Increasing analgesia may be done before the physician drains the fluid, but the physician must be notified. Warming blankets are not indicated at this time. Encouraging the child to cough, turn, and breathe deeply should be deferred till after the evaluation by the physician.
Klinefelter's syndrome:
- A. Has a karyotype XXV
- B. Is the result of meiotic non-dysjunction
- C. Shows delay in bone age/maturation
- D. Is a recognised cause of hypogonadotrophic hypogonadism
Correct Answer: B
Rationale: Klinefelter's syndrome is caused by meiotic non-dysjunction, resulting in an extra X chromosome (karyotype XXY). It is not inherited as an X-linked recessive trait, and it is not a cause of hypogonadotrophic hypogonadism.
Mitochondrial DNA
- A. Has its own genome
- B. Is responsible for some forms of myopathies
- C. Can transmit diseases from parents to children
- D. Is present in neurons
Correct Answer: B
Rationale: Is responsible for some forms of myopathies
The healthcare provider prescribes an IV solution of regular insulin (Hummulin-R) 100 units in 250 ml of 0.45% saline to infuse at 12 units/hour. The nurse should program the infusion pump to deliver how many ml/hour?
- A. 30
- B. 3
- C. 40
- D. 15
Correct Answer: A
Rationale: To calculate the infusion rate in ml/hour, the nurse needs to divide the prescribed units per hour by the concentration of insulin. 12 units/hour ÷ (100 units/250 ml) = 30 ml/hour.
In infantile eczema:
- A. The rash is characteristically present at birth
- B. The papules are itchy
- C. Cold weather relieves the symptoms
- D. A family history of related disorders is elicited in 70% of cases
Correct Answer: B
Rationale: Infantile eczema is itchy and often associated with a family history of atopy. The rash is not present at birth, and cold weather can exacerbate symptoms.
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