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A patient with a myocardial infarction (MI) is being treated with intravenous morphine. What is the primary reason for administering morphine to this patient?
- A. To reduce pain.
- B. To decrease anxiety.
- C. To reduce cardiac workload.
- D. To increase respiratory rate.
Correct Answer: C
Rationale: The primary reason for administering morphine to a patient with MI is to reduce cardiac workload. Morphine acts as a vasodilator and decreases preload and afterload on the heart, reducing myocardial oxygen demand. This helps to improve coronary blood flow and decrease the workload on the heart muscle, which is crucial in the setting of an MI.
Explanation for other choices:
A: While morphine can help reduce pain in MI, the primary reason for administering it is to reduce cardiac workload.
B: Morphine may have a calming effect, but the primary goal is to reduce cardiac workload.
D: Morphine can actually decrease respiratory rate as a side effect, making this choice incorrect.
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A patient with bipolar disorder is prescribed lithium. What dietary advice should the nurse provide?
- A. Increase intake of caffeine.
- B. Maintain a consistent salt intake.
- C. Avoid dairy products.
- D. Increase intake of green leafy vegetables.
Correct Answer: B
Rationale: The correct answer is B: Maintain a consistent salt intake. Lithium can affect sodium levels in the body, so it's important to maintain a consistent salt intake to prevent lithium toxicity or imbalance. Increasing caffeine intake (choice A) can worsen symptoms of bipolar disorder. Avoiding dairy products (choice C) is not necessary for lithium therapy. Increasing intake of green leafy vegetables (choice D) is generally healthy but not specifically recommended for lithium therapy. Maintaining a consistent salt intake is crucial in managing the effects of lithium on sodium levels.
Which problem in a client requires the most immediate intervention by the nurse?
- A. Finger paresthesias related to carpal tunnel syndrome.
- B. Increasing sharp pain related to compartment syndrome.
- C. Increasing burning pain related to a Morton's neuroma.
- D. Increasing sharp pain related to plantar fasciitis.
Correct Answer: B
Rationale: The correct answer is B. Compartment syndrome is a medical emergency that can lead to tissue damage and loss of limb function. Immediate intervention is crucial to prevent further complications. Finger paresthesias related to carpal tunnel syndrome (A) are not life-threatening and can be managed conservatively. Morton's neuroma (C) and plantar fasciitis (D) are painful conditions, but they do not pose an immediate threat to the client's health or limb function.
Why is a client with ascites scheduled for a paracentesis procedure?
- A. To diagnose liver disease
- B. To relieve abdominal pressure
- C. To assess kidney function
- D. To reduce blood pressure
Correct Answer: B
Rationale: The correct answer is B: To relieve abdominal pressure. Paracentesis is performed to drain excess fluid from the abdominal cavity, which helps alleviate symptoms like abdominal distension and discomfort in clients with ascites. It does not serve the purpose of diagnosing liver disease (A), assessing kidney function (C), or reducing blood pressure (D). The primary goal of paracentesis in this context is to provide symptomatic relief by removing the accumulated fluid, thereby reducing pressure on surrounding organs and improving the client's comfort and overall well-being.
Prior to elective surgery, a patient taking warfarin should receive which instruction regarding warfarin therapy?
- A. Continue taking warfarin until the day of surgery.
- B. Stop taking warfarin three days before surgery.
- C. Switch to aspirin before surgery.
- D. Stop taking warfarin one week before surgery.
Correct Answer: D
Rationale: The correct answer is D because stopping warfarin one week before surgery reduces the risk of excessive bleeding during the procedure. Warfarin's anticoagulant effect can persist for several days, so stopping it earlier allows time for its effects to diminish. Choice A is incorrect because continuing warfarin until the day of surgery increases bleeding risk. Choice B is incorrect as stopping warfarin only three days before surgery may not provide enough time for the anticoagulant effect to wear off. Choice C is incorrect as aspirin is not a suitable substitute for warfarin in most cases.
The sister of a patient diagnosed with BRCA gene¢â‚¬"related breast cancer asks the nurse, 'Do you think I should be tested for the gene?' Which response by the nurse is most appropriate?
- A. In most cases, breast cancer is not caused by the BRCA gene.
- B. It depends on how you will feel if the test is positive for the BRCA gene.
- C. There are many things to consider before deciding to have genetic testing.
- D. You should decide first whether you are willing to have a bilateral mastectomy.
Correct Answer: C
Rationale: The correct answer is C because genetic testing for the BRCA gene involves complex considerations beyond just the test results. By stating that there are many things to consider before deciding to have genetic testing, the nurse acknowledges the importance of discussing the potential implications of the test result, such as emotional, social, and medical factors. This response promotes informed decision-making and empowers the patient to make a well-considered choice.
Choices A, B, and D are incorrect:
A: This statement is inaccurate as a significant proportion of breast cancers are indeed linked to the BRCA gene mutations.
B: This response oversimplifies the decision-making process by focusing solely on emotional aspects, neglecting other critical factors that should be considered before genetic testing.
D: This option is not appropriate as it suggests a specific treatment option (bilateral mastectomy) without addressing the broader aspects of genetic testing and decision-making.