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A postoperative nursing goal for the infant who has had surgery to correct imperforate anus is to prevent tension on the perineum. To achieve this goal, the nurse should not place the neonate on the:
- A. Abdomen, with legs pulled up under the body.
- B. Back, with legs suspended at a 90-degree angle.
- C. Left side, with hips elevated.
- D. Right side, with hips elevated.
Correct Answer: A
Rationale: The abdominal position with legs tucked increases perineal tension, risking surgical site strain, unlike the other positions.
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The nurse is teaching a client about self-administration of insulin. Which site should the nurse recommend for fastest absorption?
- A. Abdomen
- B. Thigh
- C. Arm
- D. Buttock
Correct Answer: A
Rationale: The abdomen has the fastest insulin absorption rate due to its rich blood supply and minimal muscle interference.
The nurse is caring for a client who has just undergone a parathyroidectomy. Which of the following complications should the nurse monitor for in the immediate postoperative period?
- A. Hypocalcemia.
- B. Hyperglycemia.
- C. Hypertension.
- D. Weight loss.
Correct Answer: A
Rationale: Hypocalcemia is a potential complication post-parathyroidectomy due to reduced parathyroid hormone production.
The physician decides to change a client's current dose of I.M. meperidine hydrochloride (Demerol) to an oral dosage. The current I.M. dosage is 75 mg every 4 hours as needed. What dosage of oral meperidine should the client receive?
- A. 100 mg every 4 hours.
- B. 150 mg every 4 hours.
- C. 75 mg every 4 hours.
- D. 50 mg every 4 hours.
Correct Answer: B
Rationale: Oral meperidine has lower bioavailability than I.M., requiring a higher dose. A common conversion is 1.5–2 times the I.M. dose, making 150 mg every 4 hours appropriate.
The nurse cares for a client receiving fludrocortisone acetate for the treatment of Addison's disease. When monitoring the client for improvement, what anticipated therapeutic effect of this medication will the nurse focus on?
- A. Promote electrolyte balance.
- B. Stimulate thyroid production.
- C. Stimulate the immune response.
- D. Stimulate thyrotropin production.
Correct Answer: A
Rationale: Fludrocortisone acetate is a long-acting oral medication with mineralocorticoid and moderate glucocorticoid activity that may be used for long-term management of Addison's disease. Mineralocorticoids act on the renal distal tubules to enhance the reabsorption of sodium and chloride ions and the excretion of potassium and hydrogen ions. The client can rapidly develop hypotension and fluid and electrolyte imbalance if the medication is discontinued abruptly. The medication does not affect the immune response or thyroid or thyrotropin production.
A nurse is caring for a client with a suspected myocardial infarction. Which of the following laboratory results should the nurse prioritize?
- A. Elevated troponin levels
- B. Decreased hemoglobin
- C. Increased potassium
- D. Elevated white blood cell count
Correct Answer: A
Rationale: Troponin is a specific marker for myocardial damage and is critical in diagnosing myocardial infarction. Other results are less specific to this condition.