Nokea
A post-operative client is admitted to the post-anesthesia recovery room (PACU). The anesthetist reports that malignant hyperthermia occurred during surgery. The nurse recognizes that this complication is related to what factor?
- A. Allergy to general anesthesia
- B. Pre-existing bacterial infection
- C. A genetic predisposition
- D. Selected surgical procedures
Correct Answer: C
Rationale: Malignant hyperthermia is a rare, potentially fatal adverse reaction to inhaled anesthetics. There is a genetic predisposition to this disorder.
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A woman with chronic obstructive pulmonary disease (COPD) is admitted with an acute exacerbation. Her vital signs are: BP 162/100, pulse 78, respirations 30 and labored with wheezing. The nurse should question which of the following orders?
- A. Theophylline (Somophyllin) 0.7 mg/kg/hr IV.
- B. Tetracycline hydrochloride (Sumycin) 250 mg IM qd.
- C. Ipratropium bromide (Atrovent) inhaler 2 inhalations qid.
- D. Propranolol hydrochloride (Inderal) 40 mg PO bid.
Correct Answer: D
Rationale: Propranolol, a non-selective beta-blocker, can cause bronchoconstriction, worsening COPD. Options A, B, and C are appropriate: theophylline bronchodilates, tetracycline treats infections, and ipratropium reduces bronchospasm.
The nurse is caring for a client with a history of asthma who is experiencing an acute exacerbation. Which of the following medications should the nurse administer FIRST?
- A. Albuterol nebulizer.
- B. Prednisone PO.
- C. Montelukast PO.
- D. Ipratropium inhaler.
Correct Answer: A
Rationale: Albuterol, a short-acting beta-agonist, is the first-line treatment for acute asthma exacerbations to relieve bronchospasm and improve airflow. Options B, C, and D are secondary: prednisone reduces inflammation, montelukast prevents attacks, and ipratropium is an adjunct.
The geriatric residents of a long-term care facility are engaged in a reminiscing group. The nurse knows that the primary goal of this type of group activity is to
- A. provide psychosocial educational opportunities for stress and coping.
- B. provide an avenue for physical exercise.
- C. provide an environment for social interaction and companionship.
- D. reorient and provide a reality Test for confused clients.
Correct Answer: C
Rationale: primary goal of a reminiscing group for geriatric clients is to review and share their life experiences with the group members
A child is admitted with acute glomerulonephritis. Which finding in the client's history is most consistent with the diagnosis?
- A. A recent tick bite
- B. Pharyngitis two weeks ago
- C. A mosquito bite last week
- D. Ingestion of foods high in uric acid
Correct Answer: B
Rationale: Acute glomerulonephritis is often post-streptococcal, following pharyngitis by 1-3 weeks, due to immune complex deposition in glomeruli. Tick bites, mosquito bites, or uric acid are unrelated.
A student nurse obtaining an infant's vital signs.
Which of the following actions should the student nurse complete FIRST?
- A. Take an axillary temperature to minimize use of invasive procedures.
- B. Count respirations for 15 seconds and multiply the number by 4.
- C. Count respirations for a minute prior to arousing the infant.
- D. Use a stethoscope with a one-and-a-half-inch diaphragm to count the apical pulse.
Correct Answer: C
Rationale: Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired? (1) inappropriate to use probe to take axillary temperature (2) should count for a full minute (3) correct-respirations should be counted for one full minute prior to arousing the infant with a temperature probe or stethoscope (4) after infant is stimulated, crying may interfere with accurate evaluation of respirations