Nokea
A patient is being taught the action of digoxin, which is an inotropic agent. The nurse defines an inotropic agent as a medication that has which of the following actions?
- A. Decreases heart rate
- B. Increases conduction time
- C. Increases heart rate
- D. Strengthens heart contraction
Correct Answer: D
Rationale: The correct answer is D: Strengthens heart contraction. Digoxin is an inotropic agent that works by increasing the force of the heart's contractions. This leads to improved cardiac output and helps manage conditions like heart failure. Choices A, B, and C are incorrect because digoxin does not decrease heart rate, increase conduction time, or increase heart rate. It specifically targets the strength of the heart's contractions, making option D the most appropriate choice. This action of digoxin is crucial in improving the efficiency of the heart's pumping function.
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The nurse begins a shift assessment by examining a surgical dressing that is saturated with serosanguineous drainage on a patient who had open abdominal surgery yesterday (or 1 day ago). Which type of assessment approach is the nurse using?
- A. Gordon’s Functional Health Patterns
- B. Activity-exercise pattern assessment
- C. General to specific assessment
- D. Problem-oriented assessment
Correct Answer: C
Rationale: The correct answer is C: General to specific assessment. In this scenario, the nurse is starting with a broad assessment of the surgical dressing, which is a general observation, before moving on to more specific details. This approach allows the nurse to gather comprehensive information systematically.
A: Gordon’s Functional Health Patterns involves assessing a patient's health across several categories, not specifically related to wound care.
B: Activity-exercise pattern assessment focuses on the patient's physical activity and exercise routines, not the wound dressing.
D: Problem-oriented assessment involves identifying and addressing specific health issues, rather than starting with a general observation like the appearance of a surgical dressing.
The physician orders cystoscopy and random biopsies of the bladder for a client who reports painless hematuria. Test results reveal carcinoma in situ in several bladder regions. To treat bladder cancer, the client will have a series of intravesical instillations of bacillus Calmette-Guerin (BCG), administered 1 week apart. When teaching the client about BCG, the nurse should mention that this drug commonly causes:
- A. Renal calculi
- B. Hematuria
- C. Delayed ejaculation
- D. Impotence
Correct Answer: B
Rationale: The correct answer is B: Hematuria. Bacillus Calmette-Guerin (BCG) is commonly used in the treatment of bladder cancer. It works by stimulating the immune system to attack and destroy cancer cells in the bladder. One of the common side effects of BCG instillations is hematuria, which is the presence of blood in the urine. This can occur due to irritation of the bladder lining by the BCG solution, leading to inflammation and bleeding. It is important for the nurse to educate the client about this potential side effect so they are aware of what to expect during treatment.
A: Renal calculi - BCG therapy is not commonly associated with the formation of renal calculi.
C: Delayed ejaculation - Delayed ejaculation is not a common side effect of BCG therapy.
D: Impotence - Impotence is not a common side effect of BCG therapy.
Which of the following data regarding a client with a diagnosis of colon cancer are subjective?
- A. The client’s chemotherapy causes him nausea and loss of appetite.
- B. The client became teary when his daughter from out of state came to the bedside.
- C. The client’s ileostomy put out 125 mL of effluent in the past four hours.
- D. The patient is unwilling to manipulate or empty his ostomy bag.
Correct Answer: A
Rationale: The correct answer is A because subjective data refers to information reported by the client, such as their symptoms or feelings. In this case, the client experiencing nausea and loss of appetite due to chemotherapy is subjective as it is based on the client's personal experience and perception.
Choice B is incorrect because the client becoming teary is an observable behavior, making it an objective data point. Choice C is incorrect as the amount of effluent from the ileostomy is a measurable and quantifiable data, making it objective. Choice D is also incorrect as the patient's unwillingness to manipulate or empty his ostomy bag is an observable behavior, not based on the client's report.
One of the side effects of INH administration is peripheral neuropathy. To prevent this effect, Nurse Carlos teaches Andrew to:
- A. have a strict low cholesterol diet
- B. get extra bed rest
- C. supplement the diet with pyridoxine
- D. avoid excessive sun exposure
Correct Answer: C
Rationale: Step-by-step rationale:
1. INH (Isoniazid) can lead to peripheral neuropathy due to vitamin B6 deficiency.
2. Pyridoxine is vitamin B6, which helps prevent neuropathy.
3. Supplementing with pyridoxine can counteract the deficiency caused by INH.
4. Thus, option C, supplementing the diet with pyridoxine, is the correct choice.
Summary:
- Option A is incorrect as a low cholesterol diet does not address the vitamin B6 deficiency.
- Option B is incorrect as excessive bed rest does not prevent neuropathy.
- Option D is incorrect as sun exposure is not related to the prevention of peripheral neuropathy.
One of the complications of prolonged bed rest is decubitus ulcer. Which of the following can best prevent its occurrence?
- A. Massage reddened areas with lotion or oils
- B. Use special water mattress
- C. Turn frequently every 2 hours
- D. Keep skin clean and dry
Correct Answer: C
Rationale: The correct answer is C: Turn frequently every 2 hours. This is because changing positions regularly helps to relieve pressure on specific areas, reducing the risk of developing decubitus ulcers. Turning every 2 hours helps to maintain blood flow and prevent tissue damage.
A: Massaging reddened areas with lotion or oils can actually cause further damage by increasing friction and pressure on the skin.
B: While using a special water mattress can help distribute pressure more evenly, it is not as effective as regular turning to prevent decubitus ulcers.
D: Keeping the skin clean and dry is important for overall skin health but alone is not sufficient to prevent decubitus ulcers. Regular repositioning is crucial in reducing pressure and avoiding tissue breakdown.