Nokea
A client with acute chest pain is receiving I.V. morphine sulfate. Which of the following results are intended effects of morphine in this client? Select all that apply.
- A. Reduces myocardial oxygen consumption.
- B. Promotes reduction in respiratory rate.
- C. Prevents ventricular remodeling.
- D. Reduces blood pressure and heart rate.
- E. Reduces anxiety and fear.
Correct Answer: A,D,E
Rationale: Morphine reduces pain, which lowers myocardial oxygen demand (A), decreases blood pressure and heart rate through vasodilation and reduced sympathetic response (D), and alleviates anxiety and fear (E). It does not prevent ventricular remodeling or directly reduce respiratory rate in this context.
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A client with Parkinson's disease asks the nurse to explain to his nephew "what the doctor said the pallidotomy would do." The nurse's best response includes stating that the main goal for the client after pallidotomy is improved:
- A. Functional ability.
- B. Emotional stress.
- C. Alertness.
- D. Appetite.
Correct Answer: A
Rationale: Pallidotomy aims to improve functional ability by reducing symptoms like tremors and rigidity. Emotional stress, alertness, and appetite are not primary targets of this procedure.
The nurse is removing the client's staples from an abdominal incision when the client sneezes and the incision splits open, exposing the intestines. Which of the following actions should the nurse take next?
- A. Press the emergency alarm to call the resuscitation team.
- B. Cover the abdominal organs with sterile dressings moistened with sterile normal saline.
- C. Have all visitors and family leave the room.
- D. Call the surgeon to come to the client's room immediately.
Correct Answer: B
Rationale: Covering exposed intestines with sterile, moist dressings prevents infection and drying of tissues, stabilizing the situation until surgical intervention. This is the immediate priority.
When teaching a client with chronic obstructive pulmonary disease to conserve energy, the nurse should teach the client to lift the patient.
- A. While inhaling through an open mouth.
- B. While exhaling through pursed lips.
- C. After exhaling but before inhaling.
- D. While taking a deep breath and holding it.
Correct Answer: B
Rationale: Lifting while exhaling through pursed lips conserves energy by aligning effort with prolonged exhalation, reducing air trapping in COPD. Other methods increase respiratory workload.
Which intervention is appropriate for a client on hemodialysis?
- A. Check fistula for a thrill.
- B. Restrict all fluids.
- C. Administer heparin post-dialysis.
- D. Encourage high-protein diet.
Correct Answer: A
Rationale: Checking for a thrill ensures fistula patency for dialysis.
When teaching a client newly diagnosed with primary Addison's disease, the nurse should explain that the disease results from:
- A. Insufficient secretion of growth hormone (GH).
- B. Dysfunction of the hypothalamic pituitary.
- C. Idiopathic atrophy of the adrenal gland.
- D. Oversecretion of the adrenal medulla.
Correct Answer: C
Rationale: Primary Addison's disease is caused by idiopathic adrenal gland atrophy, leading to deficient cortisol and aldosterone production.