Nokea
A client who has undergone a subtotal thyroidectomy is subject to complications in the first 48 hours after surgery. The nurse should obtain and keep at the bedside equipment to:
- A. Begin total parenteral nutrition.
- B. Start a cutdown infusion.
- C. Administer tube feedings.
- D. Perform a tracheotomy.
Correct Answer: D
Rationale: Tracheotomy equipment is essential due to the risk of airway obstruction from swelling or hemorrhage post-thyroidectomy.
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The American Heart Association (AHA) guidelines urge greater availability of automated external defibrillators (AEDs) and people trained to use them. AEDs are used in cardiac arrest situations for:
- A. Early defibrillation in cases of atrial fibrillation.
- B. Cardiovascular placement.
- C. Early defibrillation in cases of ventricular fibrillation.
- D. None of the above
Correct Answer: C
Rationale: AEDs are used for early defibrillation in ventricular fibrillation or pulseless ventricular tachycardia, as these are shockable rhythms that can be corrected to restore cardiac function.
The nurse finds it difficult to relieve a client's pain satisfactorily. Which of the following measures should the nurse take next when continuing efforts to promote comfort?
- A. Improve the nurse-client relationship.
- B. Enlist the help of the client's family.
- C. Allow the client additional time to work through his or her own responses to pain.
- D. Arrange to have the client share a room with a client who has little pain.
Correct Answer: A
Rationale: Improving the nurse-client relationship fosters trust, enhancing pain management through better communication and tailored interventions. Family help, time, or room sharing are less direct solutions.
A client is admitted to the hospital after vomiting bright red blood and is diagnosed with a bleeding duodenal ulcer. The client develops a sudden, sharp pain in the midepigastric region along with a rigid, boardlike abdomen. These clinical manifestations most likely indicate which of the following?
- A. An intestinal obstruction has developed.
- B. Additional ulcers have developed.
- C. The esophagus has become inflamed.
- D. The ulcer has perforated.
Correct Answer: D
Rationale: Sudden, sharp midepigastric pain with a rigid, boardlike abdomen strongly suggests ulcer perforation, a life-threatening complication requiring urgent intervention. The other options do not align with these clinical manifestations.
The nurse uses a Doppler ultrasound device to assess the client's lower extremities. In addition, the nurse calculates the ankle-brachial index to estimate stenosis of the:
- A. Arteries
- B. Aorta
- C. Carotid
- D. Veins
Correct Answer: A
Rationale: The ankle-brachial index (ABI) measures the ratio of ankle to brachial systolic blood pressure to assess arterial stenosis in the lower extremities. A low ABI indicates arterial narrowing, typical in PVD. It does not assess the aorta, carotid, or veins.
A client with pancreatic cancer is experiencing severe pain and is suspected to have a malignant bowel obstruction. The nurse should anticipate an order for:
- A. A nasogastric tube.
- B. Oral laxatives.
- C. A high-fiber diet.
- D. Immediate surgery.
Correct Answer: A
Rationale: A nasogastric tube is used to decompress the bowel and relieve symptoms in malignant bowel obstruction, providing palliative relief.