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Following a thoracotomy, the client has severe pain. Which of the following strategies for pain management will be most effective for this client?
- A. Repositioning the client immediately after administering pain medication.
- B. Reassessing the client 30 minutes after administering pain medication.
- C. Verbally reassuring the client after administering pain medication.
- D. Readjusting the pain medication dosage as needed according to the client's condition.
Correct Answer: D
Rationale: Readjusting pain medication dosage based on the client's condition ensures adequate pain control, critical for recovery. Repositioning, reassessing, and reassurance are supportive but less effective alone.
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Which of the following is an appropriate expected outcome for a client recovering from a total laryngectomy? The client will:
- A. Regain the ability to taste and smell food.
- B. Demonstrate appropriate care of the gastrostomy tube.
- C. Communicate feelings about body image changes.
- D. Demonstrate sterile suctioning technique for stoma care.
Correct Answer: C
Rationale: Communicating feelings about body image changes is an appropriate psychosocial outcome post-laryngectomy, addressing adaptation to altered appearance. Taste and smell may be impaired long-term. Gastrostomy tubes are not always required. Sterile suctioning is a nursing task, not a client outcome.
The nurse is admitting a 68-year-old male to the medical floor. The echocardiogram report revealed left ventricular enlargement. The nurse notes 2+ pitting edema in the ankles when getting the client into bed. Based on this finding, what should the nurse do first?
- A. Assess respiratory status.
- B. Draw blood for laboratory studies.
- C. Insert a Foley catheter.
- D. Weigh the client.
Correct Answer: A
Rationale: Edema and left ventricular enlargement suggest heart failure, which can cause pulmonary edema. Assessing respiratory status first detects signs of respiratory distress.
The nurse is administering a medication to a client with myeloid leukemia and does not know the use, dose, or side effects. To obtain the most up-to-date information about this drug, the nurse should:
- A. Check the Physician's Drug Reference (PDR) at the nurses' station.
- B. Obtain a pharmacology textbook from the hospital library.
- C. Consult the drug guide provided by the hospital on the nurses' PDA.
- D. Review information at the drug manufacturer's website.
Correct Answer: C
Rationale: The hospital's drug guide on the nurse's PDA provides the most up-to-date and accessible information on medication use, dose, and side effects, tailored to hospital protocols. PDR and textbooks may be outdated, and manufacturer websites are less reliable for clinical use.
A client with terminal cancer is transitioning to hospice care. The nurse should prioritize which of the following in the care plan?
- A. Aggressive pain management.
- B. Curative chemotherapy.
- C. Nutritional supplementation.
- D. Physical therapy.
Correct Answer: A
Rationale: Aggressive pain management is the priority in hospice care to ensure comfort and quality of life for a client with terminal cancer.
Angiotensin-converting enzyme (ACE) inhibitors may be prescribed for the client with diabetes mellitus to reduce vascular changes and possibly prevent or delay development of:
- A. Chronic obstructive pulmonary disease.
- B. Pancreatic cancer.
- C. Renal failure.
- D. Cerebrovascular accident.
Correct Answer: C
Rationale: ACE inhibitors protect against renal failure in diabetes by reducing vascular damage and proteinuria.