Nokea
A client with seizure disorder is to receive Dilantin (Phenytoin) and Phenobarbital. The nurse knows that when she administers Phenobarbital and Dilantin (Phenytoin):
- A. A larger dose of Phenobarbital might be required.
- B. A smaller dose of Phenobarbital might be required.
- C. There will be no need to alter the amount of Phenobarbital.
- D. The two drugs cannot be given together.
Correct Answer: A
Rationale: Phenytoin induces liver enzymes, potentially reducing phenobarbital levels, so a larger dose of phenobarbital may be needed.
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An appropriate intervention for the client with suspected genitourinary trauma and visible blood at the urethral meatus is:
- A. insertion of a Foley catheter.
- B. in and out catheter specimen for urinalysis.
- C. a voided urine specimen for urinalysis.
- D. a urologist consult.
Correct Answer: D
Rationale: Blood at the urethral meatus suggests trauma, contraindicating catheterization. A urologist consult is necessary for specialized evaluation and management. Physiological Adaptation
A client with retinal detachment of the right eye has a scleral buckling with instillation of silicone oil. Post-operatively the client should be positioned:
- A. In semi-Fowler's position with the head in neutral position
- B. Supine with the head turned to the right side
- C. In low Trendelenburg position with the head in neutral position
- D. Prone with the head turned to the left side
Correct Answer: D
Rationale: Following a scleral buckling with instillation of silicone oil or gas, the client should be positioned prone with the head turned so that the operative eye is facing upward. Answers A, B, and C would displace the oil and prevent it from enhancing a seal between the retina and choroid.
The nurse should recognize that further teaching is needed when a patient with glaucoma states, 'it would be dangerous for me to:
The nurse should recognize that further teaching is needed when a patient with glaucoma states, 'it would be dangerous for me to:
- A. use any sedatives.
- B. become constipated.
- C. use atropine in any form.
- D. release my emotions by crying.
Correct Answer: C
Rationale: Atropine increases intraocular pressure, worsening glaucoma, indicating correct understanding.
A client with mastoiditis has a left mastoidectomy with tympanoplasty. The nurse should observe the client for signs of damage to the sixth crania nerve, which include:
- A. Inability to chew
- B. Inability to look laterally
- C. Inability to swallow
- D. Loss of scalp sensation
Correct Answer: B
Rationale: The sixth cranial nerve (abducens) controls lateral eye movement, so damage would result in an inability to look laterally.
Thrombus formation is a danger for all post operative patients. The nurse should act independently to prevent this complication by:
The nurse should act independently to prevent this complication by:
- A. Applying elastic stockings.
- B. Massaging gently with lotion.
- C. Encouraging in-bed exercises.
- D. Providing adequate fluids intake.
Correct Answer: C
Rationale: In-bed exercises promote venous return, reducing the risk of thrombus formation.