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Amitriptyline (Elavil) is prescribed for a patient with chronic pain from fibromyalgia. When the nurse explains that this drug is an antidepressant, the patient states that she is in pain, not depressed. What is the nurse’s best response to the patient?
- A. Antidepressants will improve the patient’s attitude and prevent a negative emotional response to the pain.
- B. Chronic pain almost always leads to depression, and the use of this drug will prevent depression from occurring.
- C. Some antidepressant drugs relieve pain by releasing neurotransmitters that prevent pain impulses from reaching the brain.
- D. Certain antidepressant drugs are metabolized in the liver to substances that numb the ends of nerve fibers, preventing the onset of pain.
Correct Answer: C
Rationale: The correct answer is C. Amitriptyline relieves pain by modulating neurotransmitter release, not solely by treating depression.
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Upon hearing that he has acute pericarditis, the patient asks how he could have contracted the disease. The best response is
- A. The upper respiratory viral infection that you experienced a couple of weeks ago could have led to acute pericarditis.
- B. It is a genetic condition that you received from your father.
- C. It is a genetic condition that you received from your mother.
- D. It is the weakening of the left side of your heart.
Correct Answer: A
Rationale: Viral infections are a common cause of acute pericarditis.
What are the factors that interfere with a client’s learning capacity? How can receptiveness to learning be increased?
- A. Stress,fatigue and lack of interest; create a supportive environment.
- B. Lack of resources; provide more materials.
- C. Cultural differences; adapt teaching methods.
- D. None of the above.
Correct Answer: A
Rationale: Factors like stress and fatigue hinder learning. Creating a supportive, stress-free environment enhances receptiveness.
A client is postoperative following an intermaxillary fixation due to multiple facial fractures. Which type of equipment should be at the client's bedside?
- A. Wire cutters
- B. NG tube
- C. Urinary catheter tray
- D. IV infusion pump
Correct Answer: A
Rationale: The correct answer is A: Wire cutters. In postoperative intermaxillary fixation, wire cutters are essential at the bedside in case of an emergency airway obstruction or need for immediate removal of the fixation. Wire cutters allow quick access to the airway without causing harm to the client.
B: NG tube is not necessary for postoperative intermaxillary fixation.
C: Urinary catheter tray is not directly related to the client's airway or fixation.
D: IV infusion pump is not specifically required for managing intermaxillary fixation emergencies.
In summary, wire cutters are crucial for ensuring client safety and airway management in postoperative intermaxillary fixation, making it the most appropriate equipment to have at the bedside.
While caring for a client receiving positive-pressure mechanical ventilation, which intervention should the nurse NOT implement to prevent complications?
- A. Elevate the head of the bed to at least 30°.
- B. Verify the prescribed ventilator settings daily.
- C. Administer pantoprazole as prescribed.
- D. Reposition the endotracheal tube to the opposite side of the mouth daily.
Correct Answer: D
Rationale: The correct answer is D. Repositioning the endotracheal tube to the opposite side of the mouth daily is not necessary and could potentially lead to complications such as accidental extubation or damage to the airway. A: Elevating the head of the bed helps prevent aspiration. B: Verifying ventilator settings daily ensures proper functioning. C: Administering pantoprazole helps prevent stress ulcers. In summary, D is incorrect because it is unnecessary and poses risks, while A, B, and C are important interventions to prevent complications associated with positive-pressure mechanical ventilation.
The health care provider has ordered IV morphine q2-4hr PRN for a patient following major abdominal surgery. When should the nurse plan to administer the morphine?
- A. Before all planned painful activities
- B. Every 2 to 4 hours during the first 48 hours
- C. Every 4 hours as the patient requests the medication
- D. After assessing the nature and intensity of the patient's pain
Correct Answer: D
Rationale: Pain assessment guides the timing and dosage of analgesics, ensuring effective pain management.