Nokea
During seizure activity which observation is the priority to enhance further direction of treatment?
- A. Observe the sequence or types of movement.
- B. Note the time from beginning to end.
- C. Identify the pattern of breathing.
- D. Determine if loss of bowel or bladder control occurs.
Correct Answer: B
Rationale: Timing seizures is crucial for determining appropriate interventions.
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Jill Means, 36, has had a vaginal radium implant placed as one of the treatments for her cervical cancer. She calls to tell you that during a coughing spell it has 'been pushed out'. You should:
- A. place signs on the door stating radioactivity danger.
- B. have Jill reinsert the applicator like a tampon.
- C. call the physician and apprise him of the situation.
- D. use forceps to place the applicator in the receptacle.
Correct Answer: D
Rationale: Signs should be placed on the door after the implant has been done, and not just when the implant is dislodged. By picking the applicator up, Jill would experience burns on her fingers/hands that would be avoidable, so need to teach her not to do so. The applicator has been contaminated, it would not be replaced in any case. Calling the physician and apprising him would certainly be necessary, but would be done after the applicator has been taken care of. Lead containers should be available to place the applicator in, and forceps would be used to do so to protect from radiation burns.
A postoperative 68-year-old opioid-naive patient is receiving morphine by patient-controlled analgesia (PCA) for postoperative pain. What is the rationale for not initiating the PCA analgesic with a basal dose of analgesic as well?
- A. Opioid overdose
- B. Nausea and itching
- C. Adverse respiratory outcomes
- D. Lack of pain control
Correct Answer: C
Rationale: The correct answer is C. Basal doses increase the risk of adverse respiratory outcomes.
Complications of self-induced vomiting in binge eating disorder include which of the following?
- A. Fluid and electrolyte disorders
- B. Damage to teeth
- C. Constipation
- D. Cardiac problems
Correct Answer: B
Rationale: Frequent vomiting exposes teeth to stomach acid, causing enamel erosion and dental damage.
Which of the following should the nurse teach the client to avoid when taking chlorpromazine HCL (Thorazine)?
- A. Direct sunlight
- B. Foods containing tyramine
- C. Foods fermented with yeast
- D. Canned citrus fruit drinks
Correct Answer: A
Rationale: Chlorpromazine increases photosensitivity, so direct sunlight should be avoided.
A preoperative patient reveals that an uncle died during surgery because of a fever and cardiac arrest. Knowing the patient is at risk for malignant hyperthermia, the perioperative nurse alerts the surgical team. What is likely to happen next?
- A. The surgery will have to be cancelled.
- B. Specific precautions can be taken to safely anesthetize the patient.
- C. Dantrolene (Dantrium) must be given to prevent hyperthermia during surgery.
- D. The patient should be placed on a cooling blanket during the surgical procedure.
Correct Answer: B
Rationale: With awareness of malignant hyperthermia risk, specific precautions ensure safe anesthesia administration.