Nokea
A small airplane crashes in a neighborhood of 10 houses. One of the victims appears to have a cervical spine injury. What should first-aid for this victim should be selected that apply.
- A. Establish an airway with the jaw-thrust maneuver.
- B. Immobilize the spine.
- C. Logroll the victim to a side-lying position.
- D. Elevate the feet 6" (15.2 cm).
- E. Place a cervical collar around the neck.
Correct Answer: A,B,E
Rationale: For a suspected cervical spine injury, the airway should be opened with the jaw-thrust maneuver, the spine immobilized, and a cervical collar applied to prevent further injury. Logrolling or elevating feet could exacerbate the injury.
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The nurse teaches the client with chronic cancer pain about optimal pain control. Which of the following recommendations is most effective for pain control?
- A. Get used to some pain and use a little less medication than needed to keep from being addicted.
- B. Take prescribed analgesics on an around-the-clock schedule to prevent recurrent pain.
- C. Take analgesics only when pain returns.
- D. Take enough analgesics around the clock so that you can sleep 12 to 16 hours a day to block the pain.
Correct Answer: B
Rationale: Taking analgesics around-the-clock prevents recurrent pain by maintaining steady drug levels, which is the most effective strategy for chronic cancer pain.
Which of the following clients with burns will most likely require an endotracheal or tracheostomy tube?
- A. Electrical burns of the hands and arms causing arrhythmias.
- B. Thermal burns to the head, face, and airway resulting in hypoxia.
- C. Chemical burns on the chest and abdomen.
- D. Secondhand smoke inhalation.
Correct Answer: B
Rationale: Thermal burns to the head, face, and airway can cause swelling and obstruction, leading to hypoxia and requiring airway management like endotracheal intubation or tracheostomy.
The nurse is preparing to apply a prescribed nitroglycerin ointment to a client. The nurse should?
- A. apply it only to the client's upper chest.
- B. rub the ointment into the client's skin until it disappears.
- C. rotate the application sites.
- D. cover the ointment with a gauze dressing.
Correct Answer: C
Rationale: Rotating sites prevents skin irritation and ensures consistent absorption.
Captopril (Capoten), furosemide (Lasix), and metoprolol (Toprol XL) are ordered for a client with systolic heart failure. The client's blood pressure is 136/82 and the heart rate is 65. Prior to medication administration at 9 a.m., the nurse reviews the following lab tests (see chart). Which of the following should the nurse do first?
- A. Administer the medications.
- B. Call the physician.
- C. Withhold the captopril.
- D. Question the metoprolol dose.
Correct Answer: B
Rationale: The potassium level of 6.8 mEq/L indicates hyperkalemia, a risk with captopril (an ACE inhibitor). Calling the physician is the priority to address this critical lab value.
A client's husband expresses concern that his dying wife keeps saying, 'I have to go to the store.' Which of the following statements by the nurse will be most effective in assisting the husband to understand the dying process?
- A. Many dying clients are restless and can be treated with sedatives.
- B. The client may be fighting death and you should leave her alone.
- C. Comments related to going somewhere or leaving on a trip are common in dying clients.
- D. Decreased circulation and lack of oxygen to the brain often causes delirium.
Correct Answer: C
Rationale: Statements about leaving or going somewhere are common in dying clients, reflecting their subconscious preparation for death, and this explanation helps the husband understand the behavior.