Nokea
A nurse is caring for a neonate born with a congenital heart abnormality. To better help the parents understand the impact of this disorder, the nurse begins by describing the unusual flow of blood through the heart which takes what course?
- A. Deoxygenated blood from the lungs enters the left atrium through the pulmonary artery.
- B. Deoxygenated blood from the lungs enters the right atrium through the pulmonary artery.
- C. Oxygenated blood from the lungs enters the right atrium through the pulmonary veins.
- D. Oxygenated blood from the lungs enters the left atrium through the pulmonary veins.
Correct Answer: D
Rationale: The correct answer is D. In a normal heart, oxygenated blood from the lungs enters the left atrium through the pulmonary veins. This oxygen-rich blood then flows into the left ventricle and is pumped out to the body. In a neonate with a congenital heart abnormality, this pathway may be disrupted, leading to potential complications.
Choice A is incorrect because deoxygenated blood from the body, not the lungs, enters the right atrium through the vena cava. Choice B is incorrect as deoxygenated blood from the lungs enters the right atrium through the superior and inferior vena cava. Choice C is incorrect as oxygenated blood from the lungs enters the left atrium, not the right atrium.
Understanding the normal flow of blood through the heart is crucial for comprehending the impact of congenital heart abnormalities on circulation and oxygenation in neonates.
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What is the responsibility of the nurse related to the patient's drug therapy? Select all that apply.
- A. Teaching the patient how to cope with therapy to ensure the best outcome.
- B. Altering the drug regime to optimize the outcome.
- C. Evaluating the effectiveness of therapy.
- D. Providing therapy as well as medications.
- E. Recommending over-the-counter medications to treat adverse effects of prescription drug therapy.
Correct Answer: A,C
Rationale: The correct answers are A and C. A nurse's responsibility related to a patient's drug therapy includes teaching the patient how to cope with therapy for optimal outcomes (A) and evaluating the effectiveness of the therapy (C). Teaching the patient ensures they understand how to take medications correctly and manage any side effects. Evaluating effectiveness allows for adjustments in the treatment plan if needed. Choices B, D, and E are incorrect. B - altering the drug regime should be done by the prescribing healthcare provider, not the nurse. D - providing therapy is beyond the scope of a nurse's responsibilities, as they focus on administering medications and supporting the patient. E - recommending over-the-counter medications falls under the purview of a pharmacist or physician, not a nurse.
A nurse is caring for a six-year-old child who had surgery that morning. The child is awake and lying very still in bed. What should the nurse do?
- A. Use an “ouch†scale for pain assessment.
- B. Encourage the child to request pain medication when needed.
- C. Plan to administer pain medication if the child begins to cry.
- D. Ask the child to rate their pain on a scale of 1 to 10.
Correct Answer: A
Rationale: The correct answer is A: Use an "ouch" scale for pain assessment. This approach is appropriate for a six-year-old child as it uses a simple and understandable method to assess pain levels. The child may not verbalize pain or cry, so using a visual scale like an "ouch" scale can help the nurse accurately assess the child's pain level. Encouraging the child to request pain medication (B) assumes the child will always feel comfortable expressing their needs, which may not be the case. Planning to administer pain medication if the child cries (C) may lead to unnecessary medication administration if the child is not in pain. Asking the child to rate their pain on a scale of 1 to 10 (D) may be too complex for a young child to understand and communicate effectively.
The nurse is preparing to assist with blood collection on a newly admitted patient who has been taking phenytoin for several years. The provider has ordered a complete blood count and liver function tests. Which other blood test will the nurse discuss with the provider?
- A. Coagulation studies.
- B. Serum electrolytes.
- C. Renal function tests.
- D. Blood glucose.
Correct Answer: D
Rationale: The correct answer is D: Blood glucose. Phenytoin can potentially affect blood glucose levels by causing hyperglycemia. Monitoring blood glucose levels is important to ensure the patient's safety and adjust medication dosages if needed.
Other choices are incorrect:
A: Coagulation studies are not typically affected by phenytoin therapy.
B: Serum electrolytes may need monitoring for other reasons, but not specifically related to phenytoin use.
C: Renal function tests are important for monitoring kidney function but are not directly influenced by phenytoin.
What is the action of the thiazide diuretic?
- A. Blocks the sodium pump.
- B. Block the chloride pump.
- C. Blocks the carbonic anhydrase pump.
- D. Blocks the potassium pump.
Correct Answer: B
Rationale: The correct answer is B: Blocks the chloride pump. Thiazide diuretics inhibit the sodium-chloride symporter in the distal convoluted tubule of the nephron, leading to increased excretion of sodium and chloride ions, resulting in diuresis. Choice A is incorrect as thiazides do not block the sodium pump. Choice C is incorrect as carbonic anhydrase inhibitors, not thiazides, block the carbonic anhydrase enzyme. Choice D is incorrect as thiazides do not block the potassium pump.
What is the action of ergotamine?
- A. Increases hypoperfusion of basilar artery vascular bed.
- B. Decreases hypoperfusion of basilar artery vascular bed.
- C. Increases hyperperfusion of basilar artery vascular bed.
- D. Decreases hyperperfusion of basilar artery vascular bed.
Correct Answer: D
Rationale: The correct answer is D: Decreases hyperperfusion of basilar artery vascular bed. Ergotamine is a vasoconstrictor that acts on serotonin receptors, reducing blood flow and decreasing hyperperfusion in the basilar artery. This helps in treating conditions like migraines by reducing the dilation of blood vessels. Choice A is incorrect because ergotamine does not increase hypoperfusion, but rather decreases hyperperfusion. Choice B is incorrect as ergotamine does not decrease hypoperfusion. Choice C is incorrect since ergotamine does not increase hyperperfusion, rather it decreases it.