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A patient scheduled for hip replacement surgery in the early afternoon is NPO but receives and ingests a breakfast tray with clear liquids on the morning of surgery. What response does the nurse expect when the anesthesia care provider is notified?
- A. Surgery will be done as scheduled.
- B. Surgery will be rescheduled for the following day.
- C. Surgery will be postponed for 8 hours after the fluid intake.
- D. A nasogastric tube will be inserted to remove the fluids from the stomach.
Correct Answer: A
Rationale: Clear liquids are generally acceptable up to 2 hours before surgery, allowing the procedure to proceed as planned.
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Derek has recently converted his outdoor garage to a gym. He has been exercising frequently in his new gym due to the convenience, even in the extreme heat. He has started taking salt tablets. The physician thinks his current symptoms may be owing to hypernatremia. His physician recognizes these as:
- A. Cardiac arrhythmias,palpitations and sinus arrest.
- B. Weakness,dizziness,abdominal distention, nausea ,vomiting, and diarrhea.
- C. Weight gain,irritability,muscle twitching and decreased myocardial contractility.
- D. Muscle cramps,malaise,constipation,rhabdomyolysis and pupillary constriction.
Correct Answer: B
Rationale: The correct answer is Weakness, dizziness, abdominal distention, nausea, vomiting, and diarrhea (B). Hypernatremia occurs when there is an excess of sodium in the body, often due to dehydration or excessive salt intake. Symptoms include gastrointestinal disturbances, neurological symptoms like confusion and dizziness, and muscle weakness.
An excited mother calls you for advice. 'My child got cleaning solution in the eyes and I rinsed it out with water. What should I do? She is still screaming!' What do you instruct the caller to do immediately?
- A. Comfort the child and check vision.
- B. Continue to irrigate eyes with water.
- C. Call Poison Control.
- D. Call 911.
Correct Answer: B
Rationale: Continuing to irrigate the eyes helps flush out any remaining chemical irritants and minimizes damage.
A client is vomiting. Which of the following actions should the nurse take first?
- A. Provide the client with an emesis basin
- B. Notify housekeeping
- C. Prevent the client from aspirating
- D. Administer an antiemetic to the client
Correct Answer: C
Rationale: The correct action for the nurse to take first is to prevent the client from aspirating. Aspiration is a serious risk when a client is vomiting as it can lead to respiratory complications. The nurse should position the client on their side to prevent aspiration of vomitus into the airway. This immediate action takes priority over providing an emesis basin, notifying housekeeping, or administering an antiemetic, which do not address the urgent need to prevent aspiration.
Which chief complaint is NOT desirable for recording on the client’s chart?
- A. CC: “cough and temperature elevation,” 2 days duration
- B. CC: “passing black stools,” 1 day duration
- C. CC: “substernal pain,” 2 hours duration
- D. Reason for contact: “physical examination for college”
Correct Answer: D
Rationale: Correct Answer: D
Rationale:
1. Chief complaints should be symptoms or concerns related to the client's health issues.
2. "Physical examination for college" is not a specific symptom or health concern.
3. Chief complaints guide healthcare providers in assessing and treating the client.
4. Recording irrelevant chief complaints can lead to confusion in diagnosis and treatment.
Summary of Incorrect Choices:
A: Describes specific symptoms, suitable for recording.
B: Describes a specific symptom (black stools), suitable for recording.
C: Describes a specific symptom (substernal pain), suitable for recording.
What is an example of a pertinent negative finding during a physical examination?
- A. Chest pain that does not radiate to the arm
- B. Elevated blood pressure in a patient with hypertension
- C. Pupils that are equal and react to light and accommodation
- D. Clear and full lung sounds in a patient with chronic bronchitis
Correct Answer: A
Rationale: The correct answer is 'Chest pain that does not radiate to the arm.' Pertinent negatives highlight clinically significant absences of expected findings, helping rule out certain conditions like cardiac ischemia.