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A physician orders a lengthy X-ray examination for a client with osteoarthritis. Which of the following actions by the nurse would demonstrate client advocacy?
- A. Contact the X-ray department and ask the technician if the lengthy session can be divided into shorter sessions.
- B. Contact the physician to determine if an alternative examination could be scheduled.
- C. Provide a dose of acetaminophen (Tylenol).
- D. Cancel the examination because of the hard X-ray table.
Correct Answer: A
Rationale: Dividing the session into shorter ones reduces discomfort, advocating for the client's comfort while ensuring the test is completed.
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A client in the PACU after spinal anesthesia reports a severe headache when sitting up. The nurse suspects:
- A. Dehydration.
- B. Post-dural puncture headache.
- C. Hypertension.
- D. Migraine exacerbation.
Correct Answer: B
Rationale: A severe headache worsened by sitting up after spinal anesthesia is characteristic of a post-dural puncture headache due to cerebrospinal fluid leakage. This requires prompt management, such as hydration or an epidural blood patch.
The nurse is assisting with a bone marrow aspiration and biopsy. In which order, from first to last, should the nurse complete the following tasks?
- A. Verify the client has signed an informed consent.
- B. Position the client in a side-lying position.
- C. Clean the skin with an antiseptic solution.
- D. Apply ice to the biopsy site.
Correct Answer: C,A,B,D
Rationale: First, the nurse must verify that the client has voluntarily signed a consent form before the procedure begins, and check that the client understands the procedure. The nurse then positions the client in a side-lying, or lateral decubitus, position with the affected side up. Then the nurse should clean the skin site and surrounding area with an antiseptic solution such as Betadine before the health care provider collects the specimen. When the procedure is finished, the nurse must apply ice to the biopsy site to reduce pain.
A client with cirrhosis begins to develop ascites. Spironolactone (Aldactone) is prescribed to treat the ascites. The nurse should monitor the client closely for which of the following drug-related adverse effects?
- A. Constipation.
- B. Hyperkalemia.
- C. Irregular pulse.
- D. Dysuria.
Correct Answer: B
Rationale: Spironolactone, a potassium-sparing diuretic, can cause hyperkalemia (B), a critical adverse effect. Constipation (A), irregular pulse (C), and dysuria (D) are not commonly associated.
A client uses timolol maleate (Timoptic) eyedrops. The expected outcome of this beta-adrenergic blocker is to control glaucoma by:
- A. Constricting the pupils.
- B. Dilating the canals of Schlemm.
- C. Reducing aqueous humor formation.
- D. Improving the ability of the ciliary muscle to contract.
Correct Answer: C
Rationale: Timolol maleate, a beta-adrenergic blocker, reduces intraocular pressure by decreasing the production of aqueous humor in the eye.
What is a priority nursing intervention for a client with renal colic?
- A. Encourage fluid intake.
- B. Administer morphine as prescribed.
- C. Apply warm compresses.
- D. Insert a urinary catheter.
Correct Answer: B
Rationale: Morphine effectively manages severe renal colic pain, prioritizing client comfort.