A patient underwent an open cholecystectomy 4 days ago, and her incision is now in the proliferative phase of healing. The nurse knows that the next step in the process of wound healing is:
- A. Inflammation
- B. Maturation
- C. Remodeling
- D. Coagulation
Correct Answer: C
Rationale: In the context of wound healing, after the proliferative phase comes the remodeling phase. During the remodeling phase, the wound gains strength as collagen fibers reorganize, and the scar matures. Inflammation is the initial phase of healing, where the body responds to injury with redness, swelling, and warmth. Maturation is the final stage where the scar tissue continues to undergo changes but is not the immediate next step after the proliferative phase. Coagulation is the process of blood clot formation and is not a phase in wound healing.
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What is the expected outcome of administering a granulocyte colony-stimulating factor (G-CSF)?
- A. Reduction in red blood cell count
- B. Decreased number of infections
- C. Decreased fatigue and increased energy
- D. Increase in white blood cell count
Correct Answer: B
Rationale: The correct answer is B: Decreased number of infections. Granulocyte colony-stimulating factor (G-CSF) is a medication used to stimulate the production of white blood cells, specifically granulocytes, in the body. By increasing the number of white blood cells, G-CSF helps in boosting the immune system, leading to a decreased number of infections. Choice A is incorrect as G-CSF does not cause a reduction in red blood cell count. Choice C is incorrect as G-CSF primarily affects white blood cells and is not directly related to fatigue or energy levels. Choice D is incorrect as G-CSF does increase the white blood cell count but does not usually elevate it to 20,000 mm3.
When administering an immunization, which of the following medications should be available?
- A. Diphenhydramine (Benadryl)
- B. Hydroxyzine (Vistaril)
- C. Physostigmine
- D. Epinephrine
Correct Answer: D
Rationale: When administering an immunization, it is essential to have epinephrine available in case of an allergic reaction such as anaphylaxis. Epinephrine is the medication of choice for treating severe allergic reactions due to its ability to reverse the symptoms rapidly. Diphenhydramine and hydroxyzine are antihistamines that can help manage mild allergic reactions but are not the primary medications for severe reactions like anaphylaxis. Physostigmine is not indicated for managing allergic reactions and is used for specific conditions such as anticholinergic toxicity.
A 45-year-old woman has been prescribed conjugated estrogens (Premarin) for the treatment of menopausal symptoms. What should the nurse include in the patient teaching?
- A. Increase fluid intake to prevent dehydration.
- B. Avoid smoking while taking this medication.
- C. Increase the intake of high-calcium foods.
- D. Take the medication at bedtime to prevent insomnia.
Correct Answer: B
Rationale: The correct answer is to 'Avoid smoking while taking this medication' because patients taking conjugated estrogens should avoid smoking due to the increased risk of cardiovascular events. Increasing fluid intake to prevent dehydration is a good practice but not specifically related to conjugated estrogens. Increasing the intake of high-calcium foods may be beneficial for bone health but is not directly related to the medication. Taking the medication at bedtime to prevent insomnia is not a specific teaching point for conjugated estrogens.
A patient with a history of osteoporosis is prescribed alendronate (Fosamax). What specific instructions should the nurse provide to ensure the effectiveness of the medication?
- A. Take the medication with a full glass of water and remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption.
- B. Take the medication with milk to enhance calcium absorption.
- C. Take the medication at bedtime to ensure absorption during sleep.
- D. Take the medication with food to prevent nausea.
Correct Answer: A
Rationale: The correct answer is A. Alendronate should be taken with a full glass of water, and patients should remain upright for at least 30 minutes to prevent esophageal irritation and ensure proper absorption. This positioning helps reduce the risk of esophageal irritation and ensures adequate drug absorption. Choice B is incorrect because alendronate should be taken with water, not milk. Choice C is incorrect as there is no specific advantage to taking alendronate at bedtime. Choice D is incorrect because taking alendronate with food may interfere with its absorption.
A patient with a history of breast cancer is prescribed tamoxifen (Nolvadex). What critical information should the nurse include in the patient education?
- A. Tamoxifen may increase the risk of venous thromboembolism, so patients should be educated about the signs and symptoms of blood clots.
- B. Tamoxifen may cause weight gain, so patients should monitor their diet.
- C. Tamoxifen may decrease the risk of osteoporosis, so patients should ensure adequate calcium intake.
- D. Tamoxifen may cause hot flashes and other menopausal symptoms.
Correct Answer: A
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.