Nokea
A patient who has been taking ibuprofen (Motrin) and imipramine (Tofranil) for control of cancer pain is having increased pain. What would the health care provider recommend as an appropriate change in the medication plan?
- A. Add PO oxycodone (Oxycontin) to the other medications
- B. Substitute PO propoxyphene (Darvon), a mild opioid, for imipramine
- C. Add transdermal fentanyl (Duragesic) to the use of the other medications
- D. Substitute PO hydrocodone with acetaminophen (Lortab, Vicodin) for the other medications
Correct Answer: C
Rationale: The correct answer is C. Adding a stronger opioid like transdermal fentanyl can address increased pain.
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Which indicates a person selected on the client’s behalf to make medical decisions when the client cannot?
- A. Durable power of attorney for healthcare
- B. Living will
- C. Advance directive
- D. Informed consent
Correct Answer: A
Rationale: A durable power of attorney for healthcare designates a proxy decision-maker, ensuring the client's wishes are honored.
What does the nurse give priority to assessing immediately following Mr. Singer’s total laryngectomy?
- A. Elimination patterns
- B. Level of pain
- C. Gag reflex
- D. Respiratory status
Correct Answer: D
Rationale: Respiratory status is critical due to the altered airway anatomy.
What diet would be most appropriate for Mr. Puff on discharge?
- A. Low-calorie, low-sodium
- B. Regular, with increase in milk and milk products
- C. Regular, with increase in onions, peas, cabbage
- D. Soft, with small frequent feedings
Correct Answer: D
Rationale: Small, frequent meals prevent overeating and reduce respiratory workload.
While caring for a client with extensive partial and full-thickness burns of the head, neck, and chest, which risk should the nurse prioritize for assessment and intervention?
- A. Airway obstruction
- B. Infection
- C. Fluid imbalance
- D. Paralytic ileus
Correct Answer: A
Rationale: The correct answer is A: Airway obstruction. This should be prioritized because burns to the head, neck, and chest can lead to swelling and inflammation, potentially compromising the airway. Maintaining a clear airway is crucial for oxygenation and ventilation. If the airway becomes obstructed, it can quickly lead to respiratory distress or failure. Assessing for signs of airway compromise and intervening promptly is essential to prevent serious complications.
Choices B, C, and D are incorrect because while infection, fluid imbalance, and paralytic ileus are also important considerations in burn care, they are not as immediately life-threatening as airway obstruction in this case. Infection can be managed with appropriate wound care, fluid imbalance can be addressed with fluid resuscitation, and paralytic ileus can be treated with medications and bowel management strategies.
What is the most common cause of amblyopia?
- A. Strabismus
- B. Cataracts
- C. Astigmatism
- D. Glaucoma
Correct Answer: A
Rationale: Strabismus, or misalignment of the eyes, is the leading cause of amblyopia in children.