Nokea
An adult is to receive narcotic analgesics via patient controlled analgesia. The nurse is evaluating client's understanding of the procedure. Which of the following statements by the client indicates that she understand PCA?
- A. When I press this button the machine will always give me more medicine
- B. I will press the button whenever I feel pain
- C. I should press this button every hour so the pain doesn't come back
- D. With this machine I will experience no more pain
Correct Answer: B
Rationale: Statement B, "I will press the button whenever I feel pain," indicates that the client understands how to use the patient-controlled analgesia (PCA). PCA systems are designed to allow patients to self-administer a predetermined dose of pain medication when needed. This statement demonstrates the client's comprehension that it is appropriate to use the PCA when pain is experienced, navigating the misunderstanding that pressing the button will always give more medicine (A), that it should be pressed on a scheduled basis regardless of pain (C), or that it will completely eliminate pain (D).
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Which of the ff finding would confirm that a female client has mastitis? Choose all that apply
- A. A crack in the nipple or the areola
- B. Multiple lumps within the breast tissue
- C. Swollen, firm, and hard breasts
- D. Enlargement of the axillary lymph nodes
Correct Answer: C
Rationale: Mastitis is an inflammatory condition of the breast tissue, often caused by an infection. Common symptoms of mastitis in a female client include swollen, firm, and hard breasts. These changes in breast tissue texture are indicative of inflammation and infection. Other possible signs of mastitis may include redness, warmth, and tenderness in the affected breast. The presence of swollen, firm, and hard breasts would confirm the diagnosis of mastitis in a female client.
A client has been diagnosed with type 1 diabetes mellitus. When teaching the client and family how diet and exercise affect insulin requirements, the nurse should include which guideline?
- A. "You'll need more insulin when you exercise or increase your food intake."
- B. "You'll need less insulin when you exercise or reduce your food intake."
- C. "You'll need less insulin when you increase your intake."
- D. "You'll need more insulin when you exercise or decrease your food intake."
Correct Answer: B
Rationale: When a client with type 1 diabetes mellitus exercises or reduces their food intake, it can lead to a decrease in blood glucose levels. This is because the body is using up glucose for energy during exercise or receiving less glucose from food intake. As a result, the client would require less insulin to manage their blood glucose levels, since there is less glucose present in the bloodstream that needs to be regulated. It is important for the client and family to understand this relationship between diet, exercise, and insulin requirements to effectively manage the client's diabetes.
The physician orders cystoscopy and random biopsies of the bladder for a client who reports painless hematuria. Test results reveal carcinoma in situ in several bladder regions. To treat bladder cancer, the client will have a series of intravesical instillations of bacillus Calmette-Guerin (BCG), administered 1 week apart. When teaching the client about BCG, the nurse should mention that this drug commonly causes:
- A. Renal calculi
- B. Delayed ejaculation
- C. Hematuria
- D. Impotence
Correct Answer: C
Rationale: Bacillus Calmette-Guerin (BCG) is a form of immunotherapy used to treat bladder cancer by stimulating the immune system to attack cancer cells in the bladder. One of the common side effects of BCG therapy is hematuria, which is the presence of blood in the urine. This can be expected due to the irritation caused by the BCG instillations in the bladder lining. Hematuria is usually mild to moderate and can resolve on its own without specific treatment.
A seizure characterized by loss of consciousness and tonic spasms of the trunk and extremities rapidly followed by repetitive generalized clonic jerking is classified as:
- A. Focal seizure
- B. Jacksonian seizure
- C. Generalized seizure
- D. Partial seizure
Correct Answer: C
Rationale: The description provided aligns with the characteristics of a generalized seizure. Generalized seizures involve abnormal electrical activity in the entire brain, leading to loss of consciousness and widespread motor symptoms, such as tonic (stiffening) and clonic (jerking) movements affecting both sides of the body. Examples of generalized seizures include tonic-clonic seizures (formerly known as grand mal seizures) where there is a sequence of tonic stiffness followed by clonic jerking. In contrast, focal (partial) seizures originate in a specific area of the brain and may result in localized symptoms before possibly spreading to involve both sides of the brain. Jacksonian seizures specifically refer to focal seizures with motor symptoms that spread in a stepwise fashion, starting from one part of the body.
When is isotretinoin (Accutane) indicated for the treatment of acne during adolescence?
- A. The acne has not responded to other treatments.
- B. The adolescent is or may become pregnant.
- C. The adolescent is unable to give up foods causing acne.
- D. Frequent washing with antibacterial soap has been unsuccessful.
Correct Answer: A
Rationale: Isotretinoin (Accutane) is a potent medication used for severe acne that has not responded to other treatments, such as topical medications or antibiotics. It is typically considered as a last resort due to its potential side effects and risks. Adolescents with resistant, severe acne who have not seen improvement with other therapies may be good candidates for isotretinoin treatment. It is important for the prescribing healthcare provider to carefully assess the severity of the acne and weigh the benefits against the potential risks before initiating isotretinoin therapy.