Pharmacology and the Nursing Process 10th Edition Test Bank

Pharmacology and the Nursing Process 10th Edition Test Bank Related

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A patient returns from surgery ff. a TURP with a three-way Foley catheter and continuous bladder irrigation. Postoperative orders include Meperidine (Demerol) 75 mg IM q3h as needed for pain, belladonna and opium (B&O) suppository q4h as needed, and strict I&O. the patient complains of painful bladder spasms, and the nurse observes blood-tinged urine on the sheets. Which action should the nurse take?

  • A. Give Demerol
  • B. Give B&O suppository
  • C. Warm the irrigation solution to body temperature
  • D. Notify the physician stat
Correct Answer: D

Rationale: The correct action for the nurse to take is to notify the physician stat (choice D). Firstly, the patient presents with painful bladder spasms and blood-tinged urine, indicating a potential complication post-TURP. This warrants immediate medical attention to assess for possible bladder injury or hemorrhage. Giving Demerol (choice A) or B&O suppository (choice B) may provide symptomatic relief but does not address the underlying issue. Warming the irrigation solution (choice C) is not a priority in this situation and does not address the potential serious complications. Notifying the physician immediately allows for prompt evaluation and appropriate intervention to address the patient's condition effectively.

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A client was brought to the emergency room with complains of difficulty of breathing. What can lead the nurse to suspect that the client is experiencing acute respiratory distress syndrome (ARDS)?

  • A. paO2 of 95, pCO2 of 43, x-ray showing enlarged heart, bradycardia
  • B. Thick green sputum production, paO2 of 74, pH of 7.41
  • C. restlessness, suprasternal retractions, paO2 of 62
  • D. wheezes, slow, deep respirations, pCO2 of 52, pH of 7.35
Correct Answer: C

Rationale: Step-by-step rationale for choice C being correct:
1. Restlessness: Indicates increased work of breathing and hypoxia.
2. Suprasternal retractions: Sign of respiratory distress.
3. paO2 of 62: Indicates severe hypoxemia, common in ARDS.
Summary:
A: Enlarged heart on x-ray does not directly indicate ARDS.
B: Thick green sputum suggests infection, not specific to ARDS.
D: Wheezes and slow respirations are not typical of ARDS, and pCO2 is normal in ARDS.

When teaching a preoperative older patient, which of the following is a technique to improve learning?

  • A. Sit in front of window in bright sunlight.
  • B. Speak in high tone.
  • C. Use small, white-on-black printed
  • D. Eliminate background noise. materials.
Correct Answer: D

Rationale: The correct answer is D, "Eliminate background noise." This technique is essential for older patients as they may have age-related hearing impairments. By reducing background noise, the patient can better focus on the information being conveyed. Sitting in bright sunlight (A) may cause glare and make it difficult to read or see clearly. Speaking in a high tone (B) may be perceived as aggressive or patronizing. Using small, white-on-black printed materials (C) may be challenging for older patients with visual impairments. Thus, eliminating background noise is the most effective technique to improve learning in preoperative older patients.

A patient is diagnosed with acute bacterial conjunctivitis. In providing patient teaching the nurse would tell the patient that this condition is more commonly known as which of the following?

  • A. Glaucoma
  • B. Color blindness
  • C. Astigmatism
  • D. Pinkeye
Correct Answer: D

Rationale: The correct answer is D: Pinkeye. Acute bacterial conjunctivitis is commonly referred to as "pinkeye" due to the characteristic pink or red appearance of the eye. This condition is caused by a bacterial infection of the conjunctiva, the thin membrane that covers the white part of the eye and inner eyelids. The term "glaucoma" (A) refers to a different eye condition characterized by increased intraocular pressure, while "color blindness" (B) is a genetic condition affecting color vision. "Astigmatism" (C) is a refractive error related to the shape of the cornea or lens, not an infection of the eye. Therefore, the correct answer is D as it accurately identifies the common name for acute bacterial conjunctivitis.

The nurse establishes trust and talks with a school-aged patient before administering an injection. Which type of implementation skill is the nurse using?

  • A. Cognitive
  • B. Interpersonal
  • C. Psychomotor
  • D. Judgmental
Correct Answer: B

Rationale: The correct answer is B: Interpersonal. The nurse is using interpersonal skills by establishing trust and communicating with the patient before administering the injection. This helps build rapport and alleviate anxiety. Cognitive skills involve problem-solving and critical thinking, not direct patient interaction. Psychomotor skills relate to physical tasks like giving injections. Judgmental skills involve making decisions based on critical thinking, not directly related to patient communication.

In teaching a female client who is HIV positive about pregnancy, the nurse would know more teaching is necessary when the client says:

  • A. “The baby can get the virus from my placenta.”
  • B. “I’m planning on starting on birth control pills.”
  • C. “Not everyone who has the virus gives birth to a baby who has the virus.”
  • D. “I’ll need to have a C-section if I become pregnant and have a baby.”
Correct Answer: B

Rationale: The correct answer is B because starting birth control pills does not protect against HIV transmission to the baby during pregnancy. The other choices demonstrate understanding of HIV transmission risks and prevention methods. A shows awareness of vertical transmission, C recognizes that not all babies born to HIV-positive mothers are infected, and D acknowledges the potential need for a C-section to reduce transmission risk. Starting birth control pills is unrelated to preventing mother-to-child HIV transmission during pregnancy.

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