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After a lobectomy for lung cancer, the nurse instructs the client to perform deep-breathing exercises to:
- A. Decrease blood flow to the lungs for rest and increased surface alveoli ventilation.
- B. Elevate the diaphragm to enlarge the thorax so that the lung surface area available for gas exchange is increased.
- C. Control the rate of air flow to the remaining lobe to decrease the risk of hyperinflation.
- D. Expand the alveoli and increase lung surface available for ventilation.
Correct Answer: D
Rationale: Deep-breathing exercises expand alveoli, increasing lung surface area for ventilation post-lobectomy.
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A client with a diagnosis of myasthenia gravis is prescribed pyridostigmine (Mestinon). The nurse should teach the client to take the medication:
- A. On an empty stomach.
- B. With meals to reduce side effects.
- C. At bedtime to promote sleep.
- D. As needed for muscle weakness.
Correct Answer: B
Rationale: Pyridostigmine should be taken with food to reduce gastrointestinal side effects like nausea.
You are caring for a group of elderly clients, many of whom are affected with multiple chronic disorders and are also, at times, affected with some acute disorders that require medical and nursing attention. As you are caring for these clients some will need a new medication regimen for an acute disorder. You should consider that fact that the elderly population is at risk for more side effects, adverse drug reactions, and toxicity and over dosages of medications because the elderly have a (n):
- A. Increased creatinine clearance.
- B. Impaired immune system.
- C. Decreased hepatic metabolism.
- D. Increased bodily fat.
Correct Answer: C
Rationale: Elderly individuals often have decreased hepatic metabolism due to reduced liver function, which affects drug metabolism and increases the risk of side effects, adverse reactions, and toxicity.
A client with a diagnosis of Parkinson's disease is prescribed levodopa-carbidopa (Sinemet). The nurse should teach the client that this medication works by:
- A. Reducing muscle spasms.
- B. Increasing dopamine levels in the brain.
- C. Blocking acetylcholine receptors.
- D. Decreasing serotonin levels.
Correct Answer: B
Rationale: Levodopa-carbidopa increases dopamine levels in the brain, helping to alleviate Parkinson's symptoms.
A client with Alzheimer's disease is started on a low dose of lorazepam (Ativan) because of agitation and a sleep disturbance. The nurse should assess the client for which of the following?
- A. Nightingale agitation
- B. Extrapyramidal side effects
- C. Vomiting
- D. Anticholinergic side effects
Correct Answer: D
Rationale: Lorazepam, a benzodiazepine, can cause anticholinergic side effects such as dry mouth, constipation, or confusion, especially in elderly clients with Alzheimer's. Extrapyramidal effects are associated with antipsychotics, and vomiting is less common.
When witnessing an adult client's signature on a consent for a procedure, the nurse verifies that the consent was obtained in an appropriate manner. The nurse should verify which of the following? Select all that apply.
- A. That there was adequate disclosure of information.
- B. That the client understood the information.
- C. That there was voluntary consent on the client's part.
- D. That the client has full awareness of the potential complications.
- E. That the client's relative, spouse or legal guardian was present.
Correct Answer: A,B,C,D
Rationale: Informed consent requires adequate disclosure, client understanding, voluntary consent, and awareness of complications. A relative's presence is not mandatory unless the client is incapacitated.