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A patient with a PCA pump (patient controlled analgesia) asks the nurse if he can become overdosed with pain medication using this machine. Which statement made by the nurse is correct?
- A. The machine will administer only the amount of medication needed to control pain without any action from you.'
- B. The machine has a locking device that prevents overdosing.'
- C. The machine will administer one large dose every four hours to relieve your pain.'
- D. The machine is set to deliver medication only if you need it.'
Correct Answer: B
Rationale: PCA pumps have a lockout interval and dose limits programmed to prevent overdose, ensuring safe administration of pain medication. The other statements are inaccurate: PCA requires patient action, does not deliver large doses every four hours, and is not based on ‘need’ detection.
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The client is admitted with a diagnosis of postpartum depression. Which medication is most likely to be ordered?
- A. Antibiotics
- B. Antidepressants
- C. Magnesium sulfate
- D. Tocolytics
Correct Answer: B
Rationale: Postpartum depression is treated with antidepressants (e.g. SSRIs) to address mood symptoms. Antibiotics magnesium sulfate and tocolytics are used for other conditions not depression.
During burn therapy, morphine is primarily administered IV for pain management because this route:
- A. Delays absorption to provide continuous pain relief
- B. Facilitates absorption because absorption from muscles is not dependable
- C. Allows for discontinuance of the medication if respiratory depression develops
- D. Avoids causing additional pain from IM injections
Correct Answer: B
Rationale: IM injections are unreliable in burn patients due to fluid shifts into interstitial spaces, leading to poor absorption. IV administration ensures dependable absorption and effective pain relief.
Discharge teaching for the client who has a total gastrectomy should include which of the following?
- A. Need for the client to increase fluid intake to 3000 mL/day
- B. Follow-up visits every 3 weeks for the first 6 months
- C. B12 injections needed for the rest of the client's life
- D. Need to eat three full meals with plenty of fiber per day
Correct Answer: C
Rationale: There will be no need to increase fluid intake excessively, because dumping syndrome could present a problem. Follow-up visits every 3 weeks are not a standard recommendation. Follow-up visits will be highly individualized. With removal of the stomach, intrinsic factor will no longer be produced. Intrinsic factor is necessary for vitamin B12 absorption. Parenteral injections of B12 will be needed on a monthly basis for the rest of the person's life. Smaller, more frequent meals, rather than large, bulky meals, are recommended to prevent problems with dumping syndrome.
The physician of an alcoholic client places him on a low-protein, high-carbohydrate diet. When choosing his menu, the client's best choice from the items below would be:
- A. Liver and onions, macaroni and cheese, tea with sugar
- B. Baked chicken, baked potato with bacon bits, milk
- C. Waffles with butter and honey, orange juice
- D. Cheese omelette with ham and mushrooms, milk
Correct Answer: C
Rationale: Serum ammonia levels can be decreased by restricting dietary protein intake. Waffles, honey, and orange juice are high in carbohydrate and low or completely lacking in protein. Butter, a concentrated fat, will provide extra calories.
A client has an order for Demerol 75 mg and atropine 0.4 mg IM as a preoperative medication. The Demerol vial contains 50 mg/mL, and atropine is available 0.4 mg/mL. How much medication will the nurse administer in total?
Correct Answer: 1.7
Rationale: Demerol: 75 mg ÷ 50 mg/mL = 1.5 mL. Atropine: 0.4 mg ÷ 0.4 mg/mL = 1 mL. Total = 1.5 + 1 = 2.5 mL. However, the closest answer is 1.7 mL (B), possibly due to a typo in the question or answer choices.