Nokea
A nurse assesses a client’s pain level as a 5 out of 10 on the pain scale. The order reads for the client to receive morphine. Which of the following five ways of managing pain does the drug morphine fall under?
- A. Altering pain transmission at the level of the spinal cord
- B. Combining analgesics with adjuvant drugs
- C. Blocking brain perception
- D. Interrupting pain-transmitting chemicals at the site of injury
Correct Answer: A
Rationale: The correct answer is A because morphine primarily works by altering pain transmission at the level of the spinal cord by binding to opioid receptors.
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When teaching a client with chronic obstructive pulmonary disease about oxygen by cannula, the nurse should also instruct the client's family to:
- A. Avoid smoking near the client.
- B. Turn off oxygen during meals.
- C. Adjust the liter flow to 10 as needed.
- D. Remind the client to keep mouth closed.
Correct Answer: A
Rationale: Smoking near oxygen poses a fire hazard and exacerbates respiratory issues.
A client with end-stage heart failure who is awaiting a transplant appears depressed and states, 'I know a transplant is my last chance, but I don't want to become a vegetable.' How should the nurse respond?
- A. Would you like information about advance directives?
- B. I will arrange for a psychiatrist to speak with you.
- C. Do you want to come off the transplant list?
- D. Would you like to speak with a priest or chaplain?
Correct Answer: A
Rationale: The correct answer is A: Would you like information about advance directives? This is the appropriate response as it addresses the client's concerns about becoming a vegetable and explores their wishes for end-of-life care. Advance directives can help the client make decisions about their care in case they are unable to communicate in the future. The other choices are incorrect because B assumes the client needs psychiatric evaluation, C suggests removing them from the transplant list without exploring their concerns further, and D focuses on spiritual support rather than addressing the client's specific worries about their quality of life post-transplant.
Which action best demonstrates respect for autonomy when working with a client?
- A. Asks if the client has questions before signing a consent form
- B. Provides the client with accurate information when questioned
- C. Honors the promises made to the client and family
- D. Ensures fair treatment of the client compared to others
Correct Answer: A
Rationale: The correct answer is A because asking if the client has questions before signing a consent form shows respect for autonomy by allowing the client to make an informed decision. This action promotes the client's right to self-determination and involvement in the decision-making process. Choice B focuses on providing information when questioned but may not actively involve the client in the decision-making process. Choice C refers to honoring promises and not necessarily respecting autonomy. Choice D relates to fairness but does not directly address autonomy or the client's decision-making ability.
A 72-year-old male client had the Foley catheter removed today, which was inserted during the transurethral resection of the prostate (TURP). The client is concerned about the urinary incontinence he has experienced since removal of the Foley catheter. The nurse should explain to the client that:
- A. he should not be concerned, because it will be quickly resolved.
- B. urinary incontinence is usually temporary.
- C. he should notify the nurse when this happens.
- D. this is related to the bladder spasms and will soon stop.
Correct Answer: B
Rationale: Urinary incontinence is usually temporary, but the problem may take some time to resolve, especially in an older male. Bladder spasms are not the cause of the client's incontinence.
How does the pain of a myocardial infarction (MI) differ from stable angina?
- A. Accompanied by shortness of breath
- B. Feelings of fear or anxiety
- C. Lasts less than 15 minutes
- D. No relief from taking nitroglycerin
Correct Answer: C
Rationale: The correct answer is C because the pain of a myocardial infarction (MI) typically lasts longer than 15 minutes, unlike stable angina which lasts for a shorter duration. MI pain is usually described as intense, crushing, and prolonged, whereas stable angina pain is often triggered by exertion and relieved by rest or medication like nitroglycerin. Choices A, B, and D are incorrect because shortness of breath, feelings of fear or anxiety, and lack of relief from nitroglycerin are not definitive differentiating factors between MI and stable angina.