Pharmacology and the Nursing Process 10th Edition Test Bank Quizlet

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A client with serum glucose level of 618mg/dl is admitted to the facility. He’s awake and oriented, has hot dry skin, and has the following vital signs: temperature of 100.6F (38.1C), heart rate of 116 beats/min, and blood pressure of 108/70mHg. Based on these assessment findings, which nursing diagnosis take highest priority?

  • A. Deficient volume related to osmotic diuresis
  • B. Decreased cardiac output related to elevated heart rate
  • C. Imbalanced nutrition: Less than body requirements related to insulin deficiency
  • D. Ineffective thermoregulation related to dehydration
Correct Answer: D

Rationale: The correct answer is D, "Ineffective thermoregulation related to dehydration." The client's high serum glucose level of 618mg/dl indicates severe hyperglycemia, leading to dehydration. The client's hot, dry skin and elevated temperature can be signs of dehydration, impacting the body's ability to regulate temperature. Dehydration can also affect other vital signs, contributing to the elevated heart rate and low blood pressure. Addressing ineffective thermoregulation is crucial as it can lead to further complications.
Choices A, B, and C are not the highest priority because addressing dehydration and ineffective thermoregulation takes precedence due to the immediate risk of complications such as heatstroke or hypothermia. Deficient volume, decreased cardiac output, and imbalanced nutrition are important but not as urgent in this scenario.

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A patient who has just had a TURP asks his nurse to explain why he has to have the bladder irrigation because it seems to increase his pain. Which of the following explanations by the nurse is best?

  • A. “The bladder irrigation is needed to stop the bleeding in the bladder.”
  • B. “Antibiotics are being administered into the bladder to prevent infection.”
  • C. “The irrigation is needed to keep the catheter from becoming occluded by blood clots.”
  • D. “Normal production of urine is maintained with the irrigations until healing can occur.”
Correct Answer: C

Rationale: Step 1: The nurse should explain that bladder irrigation is necessary to prevent blood clots from occluding the catheter after a TURP procedure.
Step 2: Without irrigation, blood clots could block the catheter, leading to urinary retention and potential complications.
Step 3: This explanation addresses the patient's concern about increased pain and highlights the importance of the irrigation in maintaining proper urine flow.
Step 4: Choice A is incorrect because the primary purpose of irrigation is not to stop bleeding but to prevent clot formation. Choice B is incorrect because the irrigation is not for administering antibiotics. Choice D is incorrect as it does not address the issue of clot formation.

Patients are at risk for overwhelming postsplenectomy infection (OPSI) following splenectomy. Which of the ff. symptoms alerts the nurse to this possibility?

  • A. Bruising around the operative site
  • B. Pain
  • C. Irritability
  • D. Fever
Correct Answer: D

Rationale: The correct answer is D: Fever. Following splenectomy, patients are at risk for OPSI due to impaired immune response. Fever is a key symptom of infection and should alert the nurse to this possibility. Bruising around the operative site (A) is expected post-surgery. Pain (B) is common after surgery and may not specifically indicate OPSI. Irritability (C) is a vague symptom and not specific to OPSI. In summary, fever is the most concerning symptom as it can indicate an underlying infection in a postsplenectomy patient.

A nurse is formulating a diagnosis for a client who is reliving a brutal mugging that took place several months ago. The client is crying uncontrollably and states that he 'can’t live with this fear.' Which of the following diagnoses for this client is correctly written?

  • A. Post-trauma syndrome related to being attacked
  • B. Psychological overreaction related to being attacked
  • C. Needs assistance coping with attack
  • D. Mental distress related to being attacked
Correct Answer: A

Rationale: The correct answer is A: Post-trauma syndrome related to being attacked. This diagnosis accurately reflects the client's symptoms of reliving the traumatic event, crying uncontrollably, and expressing fear. Post-trauma syndrome encompasses a range of symptoms following a traumatic event, such as flashbacks, anxiety, and emotional distress. The other choices are incorrect because they are either too vague (B: Psychological overreaction) or do not capture the specific nature of the client's symptoms (C: Needs assistance coping; D: Mental distress). Therefore, option A is the most appropriate diagnosis based on the client's presentation.

Then the drug is stopped. When should treatment resume?

  • A. When the WBC falls to 5,000mm3
  • B. When the WBC count rises to
  • C. When lost hair begins to grow back 50,000/mm3
  • D. When the client displays anemia
Correct Answer: A

Rationale: The correct answer is A because the drug should be resumed when the WBC count falls to 5,000mm3 to ensure the client's safety and efficacy of treatment. This criterion indicates that the client's immune system has recovered sufficiently to tolerate the drug. Choices B, C, and D are incorrect because they do not directly correlate with the client's immune system recovery, which is crucial for drug tolerance. Choice B focuses on the rise in WBC count, not the fall to a specific level. Choice C is related to a cosmetic side effect, not clinical readiness. Choice D is unrelated to immune system recovery.

A nurse is providing education to a patient about self-administering subcutaneous injections. The patient demonstrates the self-injection. Which type of indicator did the nurse evaluate?

  • A. Health status NursingStoreRN
  • B. Health behavior
  • C. Psychological self-control
  • D. Health service utilization
Correct Answer: B

Rationale: The correct answer is B: Health behavior. Evaluating the patient's demonstration of self-injection assesses their ability to perform a specific health-related action. This choice focuses on the patient's actions and behaviors related to their health, aligning with the scenario provided.

Choice A: Health status is incorrect because it refers to the patient's current physical condition, not their ability to perform a specific health action.

Choice C: Psychological self-control is incorrect as it pertains to the patient's ability to regulate their emotions and impulses, not their ability to self-administer injections.

Choice D: Health service utilization is incorrect as it relates to the frequency and pattern of healthcare services used by the patient, not their ability to perform a specific health behavior.

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